Gait kinematics and clinical test changes in post-stroke patients during rehabilitation. Preliminary results of 12 patients of randomized clinical trial

摘要

More precise knowledge concerning gait patterns of movement in stroke patients incorporating modern diagnostic tools is necessary. Exact information about qualitative and quantitative changes during the process of rehabilitation based on reeducation of functions and relating it to possible changes of motor deficit will possibly lead to better physiotherapy planning.Goal of this study is to assess some components and changes of gait pattern and motor deficit after stroke to develop better physiotherapy this group of patientsMaterials and methods Consecutively admitting to rehabilitation unit first stroke patients who met inclusion criteria ( time from the onset of stroke between 1~(st) and 3th month, independent walking skills on the distance of 10m, motor deficit, self awareness of disease, signed inform consent form) were enrolled to the study. Patients were participating in physiotherapy five days a week for 12 weeks. Rivermead Motor Assessment (Lower Extremity Section), Fugl-Meyer Motor Deficit Scale, Nottingham Extended Activities of Daily Living Scale and three-dimension motion analysis system Vicon 460 (amplitude of hip joint range of motion, walking speed, cadence, steps length) were used. All measurement procedures were carried out three times: before therapy, after 6 weeks and after 12 weeks of treatment.Results: Twelve patients were enrolled to the study (4 female, 8 man, mean age 58 years old, 5 persons suffering from right side paresis). All patients improved after 6 and 12 weeks. Alterations were related both to clinical assessment and to objective movement analysis and they were positively correlated. Mean motor deficit (FM) stated 140,148, 161p, ADL -30, 42, 47p., walking speed: 0,4m/s, 0,5m/s, 0,6m/s, cadence (steps/min):70, 81, 89.Conclusions: Results indicate relatively constant progress of motor abilities in this group of patients however it decreased during second period. Clinical improvements were accompanied by similar progress of walking speed and cadence. Further studies are necessary.