Article

Post-stroke hemiparetic subjects walk with asymmetrical step lengths that are
highly variable between subjects and may be indicative of the underlying
impairments and compensatory mechanisms used. The goal of this study was to
determine if post-stroke hemiparetic subjects grouped by step length asymmetry
have similar abnormal walking biomechanics compared to non-impaired walkers.
Kinematic and ground reaction force data were recorded from 55 hemiparetic
subjects walking at their self-selected speed and 21 age and speed-matched
non-impaired control subjects. Hemiparetic subjects were grouped by paretic step
ratio, which was calculated as the paretic step-length divided by the sum of
paretic and nonparetic step-lengths, into high (>0.535), symmetric (0.535-0.465)
and low (<0.465) groups. Non-parametric Wilcoxin signed-rank tests were used to
test for differences in joint kinetic measures between hemiparetic groups and
speed-matched control subjects during late single-leg stance and pre-swing. The
paretic leg ankle moment impulse was reduced in all hemiparetic subjects
regardless of their paretic step ratio. The high group had increased nonparetic
leg ankle plantarflexor and knee extensor moment impulses, the symmetric group
had increased hip flexor moment impulses on both the paretic and nonparetic leg
and the low group had no additional significant differences in joint moment
impulses. These results suggest that the direction of asymmetry can be used to
identify both the degree of paretic plantarflexor impairment and the compensatory
mechanisms used by post-stroke hemiparetic subjects.
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