Comparison of biomechanical parameters in lower limb joints of stroke patients according to conventional evaluation scores during level walking

HyeongMin Jeon; Eun-Hye Chung; Se-Young Bak; Heegoo Kim; Seyoung Shin; Hongseok Baek; MinYoung Kim

doi:10.3389/fbioe.2024.1320337

Comparison of biomechanical parameters in lower limb joints of stroke patients according to conventional evaluation scores during level walking

Front Bioeng Biotechnol. 2024 Feb 26:12:1320337. doi: 10.3389/fbioe.2024.1320337. eCollection 2024.

Authors

HyeongMin Jeon^{1

2}, Eun-Hye Chung², Se-Young Bak², Heegoo Kim¹, Seyoung Shin^{1

2}, Hongseok Baek², MinYoung Kim^{1

2}

Affiliations

¹ Digital Therapeutics Research Team, CHA Bundang Medical Center, CHA Future Medicine Research Institute, CHA University School of Medicine, Seongnam, Republic of Korea.
² Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.

Abstract

Objective: Patients with chronic stroke capable of independent gait were classified into functional ambulation category (FAC) 4 or 5, and the kinetic and kinematic data on their lower limb joints on the affected and unaffected sides were compared with that of healthy individuals. Finally, the qualitative changes in the gait of patients with stroke were investigated based on the differences in FAC scores. Methods: Twelve healthy participants and 19 patients with stroke capable of independent gait were included. The three-dimensional (3D) motion analysis and conventional assessment were conducted for all patients with stroke. Results: The FAC 5 group exhibited a larger range of motion (ROM) than the FAC 4 group in knee and hip joints on the affected side and only in the hip on the unaffected side. In the FAC 5 group, ROM differences in the healthy group on either the affected or unaffected side were absent. The peak of the hip flexion moment on the affected side in both the FAC 4 and 5 groups was smaller than that in the healthy group and in the FAC 4 group on the unaffected side. The absorption power minimum on the affected side was smaller only in the FAC 4 group than that in the healthy group and was larger in the FAC 5 group than that in the FAC 4 group. On the unaffected side, the absorption power minimum was smaller only in the FAC 4 group than that in the healthy group. Conclusion: Functional differences in gait were found in patients classified based on conventional evaluation capable of independent gait after post-stroke rehabilitation. Patients may not exhibit complete recovery in the kinetic indices even if they are judged to be normal in the conventional evaluation, and the kinematic gait indices indicate recovery. Evaluating kinetic indices in addition to kinematic indices is necessary, and joint power may be an especially useful index.

Keywords: affected side; functional ambulation category; gait; kinematics; kinetics; motion analysis; stroke; unaffected side.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the IITP grant of the Ministry of Science and ICT (2021-0-00742; Development of Core Technology for Whole-body Medical Twin), the Basic Science Research Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Education and Science (2022R1F1A1064485), and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: RS-2023-00262005).