Abstract

Background: Recovery of walking after stroke requires an understanding of how motor control deficits lead to gait impairment. We compared gait patterns and trunk movements of chronic ischemic stroke patients and sex-matched controls.

Methods: Ten patients with chronic ischemic stroke and ten healthy controls were enrolled. An automated trunk three-axial accelerometer-based gait analysis system was used to investigate spatiotemporal gait parameters, including walking speed, step length, and cadence. Trunk movement intensity was measured as the acceleration root mean square. Trunk movement symmetry and regularity were analyzed using the autocorrelation method. Correlations between gait parameters and future falls were studied.

Results: The median time until evaluation following stroke was 30 months. Walking speed, step length, cadence, and trunk movement intensity (p < 0.001, p < 0.001, and p = 0.001, respectively) were significantly lower for the stroke group. Trunk movement symmetry (p = 0.005) and regularity (p = 0.029) in the vertical axis differed between groups. Future falls were positively associated with trunk movement symmetry and regularity in the anteroposterior axis and root mean square ratio in the medio-lateral axis; however, they were negatively associated with walking speed and trunk movement intensity in the anteroposterior direction.

Conclusions: Patients with chronic stroke develop trunk movement asymmetry and irregularity in a vertical direction, which can contribute to muscular imbalances and potential injury. The trunk accelerometer may have a potential role in evaluating rehabilitation outcomes for stroke patients to regain better mobility, trunk control and stable gait.