Assessment of ambulation functions through kinematic analysis in individuals with stroke: a systematic review.
Jiaqi Li, Patrick W Kwong, Wang Lin and 3 others
PMID 40008910WHAT IT FOUND
Many lower-limb motion metrics after stroke have been tested, but the evidence that they are consistent and meaningful is mostly moderate to low.
Most studies looked at walking, so use these metrics cautiously in daily mobility decisions.
Key findings
01The review included 383 studies involving 8109 individuals with stroke.
02The review analysed 91 combined lower-limb metrics, and 335 studies were grouped under the walking task.
03Twenty-three metrics had sufficient reliability and six metrics displayed high validity, but 12 of 13 high-quality studies were rated moderate evidence quality and one low.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Most clinimetric studies had fewer than 50 participants, so the reliability and validity findings are imprecise. The review focused heavily on walking, with far fewer studies on turning, sit-to-stand, step-over, and other tasks, so it may not cover all real-world mobility needs. Studies defined and measured kinematic metrics differently, so consistent conclusions are difficult. Only English studies were included, and keyword searching may have missed papers that named metrics in titles or abstracts. Validity was judged mainly against walking speed and lower-limb Fugl-Meyer scores, so metrics correlated with other clinical outcomes were not assessed. Studies with fewer than 30 participants were excluded from the clinimetric property assessment.
Declared interests
The authors declared no conflict of interest with any financial organization. The work was funded by a grant from the Hong Kong Polytechnic University.
The easy way to misread this
Do not conclude that instrumented motion metrics are proven better than clinical gait tests. The review found many metrics, but the evidence that they are consistent and meaningful was mostly moderate to low, and most studies were small.