Longitudinal changes in vertical stride regularity, hip flexion, and knee flexion contribute to the alteration in gait speed during hospitalization for stroke

Abstract

Changes in stride regularity and joint motion during gait appear to be related to improved gait speed in hospitalized patients with stroke. We aimed to clarify the changes in stride regularity and joint motion during gait through longitudinal observations. Furthermore, we aimed to clarify the relationship between changes in gait speed, stride regularity, and joint motion during gait. Seventeen inpatients with stroke were assessed for physical and gait functions at baseline, when they reached functional ambulation category 3, and before discharge. Physical function was assessed using the Fugl-Meyer assessment for the lower extremities and the Berg Balance Scale. Gait function was assessed on the basis of gait speed, joint motion, stride regularity, and step symmetry using inertial sensors. The correlations between the ratio of change in gait speed and each indicator from baseline to discharge were analyzed. Both physical and gait functions improved significantly during the hospital stay. The ratio of change in gait speed was significantly and positively correlated with the ratio of change in vertical stride regularity (r = 0.662), vertical step symmetry (rs = 0.627), hip flexion (rs = 0.652), knee flexion (affected side) (r = 0.611), and ankle plantarflexion (unaffected side) (rs = 0.547). Vertical stride regularity, hip flexion, and knee flexion (affected side) were significant factors in determining the ratio of changes in gait speed. Our results suggest that stride regularity, hip flexion, and knee flexion could explain the entire gait cycle and that of the affected side. These parameters can be used as indices to improve gait speed.