Bilateral ankle deformities affects gait kinematics in chronic stroke patients

Hogene Kim; Ji-Eun Cho; Kyeong-Jun Seo; Jooyoung Lee

doi:10.3389/fneur.2023.1078064

Bilateral ankle deformities affects gait kinematics in chronic stroke patients

Front Neurol. 2023 Feb 9:14:1078064. doi: 10.3389/fneur.2023.1078064. eCollection 2023.

Authors

Hogene Kim^{1

2}, Ji-Eun Cho², Kyeong-Jun Seo², Jooyoung Lee³

Affiliations

¹ Department of Clinical Rehabilitation Research, National Rehabilitation Center, Seoul, Republic of Korea.
² Translational Research Center on Rehabilitation Robots, National Rehabilitation Center, Seoul, Republic of Korea.
³ Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea.

Abstract

Objectives: Stroke patients suffer from ankle joint deformities due to spastic ankle muscles. This study evaluated the viability of using 3D scanned surface images of the feet of stroke victims to visually assess the deformities of a hemiparetic foot and investigated the influences of deformed ankle joints on gait kinematics.

Methods: A total of 30 subjects with stroke-induced hemiparesis and 11 age-matched healthy controls completed the clinical assessments. We analyzed their feet's morphometric characteristics using a 3D scanner, identified convenient anthropometric measurements, and conducted gait trials on even and uneven terrains. The 3D foot morphometric characteristics were evaluated using the geometric morphometrics method (GMM).

Results: Results showed that there were significant differences in bilateral foot shapes between the chronic stroke patients and healthy controls and between the paretic and non-paretic sides in the chronic stroke patients. In stroke patients, those with the smaller medial malleoli's vertical tilt angles showed significantly different ankle ranges of motion of dorsi-/plantar flexion during gaits on uneven terrains (p = 0.009). In addition, those with the greater medial malleoli's vertical tilt angles showed significantly different ankle ranges of motion of inversion/eversion during gaits on even and uneven terrains (p < 0.05).

Conclusion: Using 3D scanning technology, bilateral morphometric changes in the feet of chronic stroke patients were shown by GMM and the simple anthropometric measurements identified its shape deformities in the feet. Their possible effects on gait kinematics while walking on uneven terrains were investigated. Current methodology can be potentially useful in applying conventional productions of clinically manufactured, patient-fitted ankle-foot-orthosis in orthotics and prosthetics, and in detecting various unidentified pathological deformities in the feet.

Keywords: 3D scan; ankle; ankle-foot-orthosis; anthropometry; deformity; foot; geometric morphometrics; stroke.

Grants and funding

This work was supported by Translational Research Center for Rehabilitation Robots, Korea National Rehabilitation Center, Ministry of Health and Welfare, Korea. Award Number: #NRCTR-IN20003. Grant Recipient: HK.