| 제목 |
Correlation between Lower Limb Motor Function and Gait Characteristics in Chronic Stroke Patients |
| 소속 |
Samsung Medical Center, Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute1, Sungkyunkwan University, Department of Health Sciences and Technology (SAIHST)2 |
| 저자 |
Jinuk Kim1,2, Su-Hyun Lee1, Jungsoo Lee1, Heegoo Kim1,2, Yoonju Na1, Won Hyuk Chang1, Yun-Hee Kim1,2†, Hwang-Jae Lee1,2* |
Objective: Objective and quantitative gait characteristics enable us to understand the causes of gait deficits and can help to suggest gait training and treatment appropriate for the patient. This study aimed to verify the relationship between the clinical scales associated with lower limb motor function and gait characteristics including kinematic and kinetic variables in patients with chronic stroke.
Methods: A total of 66 patients (45 males; mean age: 56.2 ± 12.7 years) with chronic stroke over six months after the onset were enrolled. The inclusion criteria were (1) hemiplegic patients over 19 years old; (2) Patients with chronic ischemic or hemorrhagic stroke over 6 months of onset; (3) independent walking with a functional ambulation category mobility (FAC) scale of 3 points or more. Patients with mild motor impairment with Fugl-Meyer assessment (FMA) score of 96 points or more were excluded in the study. Clinical scales related to lower limb motor function and gait function were measured by motricity index (MI), FMA, timed up and go test (TUG), 10-meter walking test (10MWT). Spatiotemporal parameters (gait speed, cadence, and stride length), gait symmetry (temporal symmetry and spatial step symmetry ratio/index) and kinetic and kinematic variables were measured using a three-dimensional motion capture system with 6 infrared cameras (Motion Analysis Corporation, Santa Rosa, CA). Pearson’s correlation coefficients were used to verify the correlations between clinical scales and spatiotemporal parameters, kinetic and kinematic variables. In addition, stepwise regression was performed to explore the predictive factors of the gait velocity (10MWT) among examined factors.
Results: There were significant positive correlations between clinical scales associated with lower limb and gait function and gait characteristics. FMA lower score was correlated with stride length, step length in affected side and gait symmetry in chronic stroke patients. MI (leg and trunk) scores were also significantly correlated with gait cadence and single support time. FMA lower score was significantly correlated with gait kinematic variables including peak hip flexion angle and moment and peak ankle dorsiflexion angle. A stepwise regression identified variables most useful in predicting 10MWT speed. Significant predictive factors were the gait symmetry index (temporal and spatial), MI trunk score, and FMA lower score.
Conclusions: It was confirmed that the lower limb motor function of the chronic stroke patients had a significant effect on their gait characteristics. These results suggest that the clinical scales can be used to infer gait performance in chronic stroke patients with a different level of disability. Further studies are needed to identify factors associated with gait characteristics in stroke severity and outcome in a larger study. |
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