Clinical assessments and gait characteristics by subtype classification using temporal and kinematic symmetry indices during gait in patients with chronic stroke.
Yuichiro Hosoi, Takayuki Kamimoto, Kohsuke Okada and 3 others
PMID 41216656WHAT IT FOUND
Stroke survivors who walk independently split into four distinct gait subtypes based on symmetry.
Those with severe motor impairment had the lowest walking speed and most asymmetry. However, patients with similar moderate impairment and speed showed different underlying movement problems, meaning one subtype needs different rehab than another.
Key findings
01Participants clustered into four groups: high symmetry in both time and movement; low time symmetry but high movement symmetry; high time symmetry but low movement symmetry; and low symmetry in both.
02Patients with similar moderate motor impairment and walking speed belonged to different subtypes, suggesting they used different compensatory strategies to maintain their gait.
03The subtype with low temporal symmetry had significantly worse trunk function compared to the other groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only included patients who could already walk independently for 10 meters without aids, so findings do not apply to patients with more severe mobility limitations. Gait analysis was conducted barefoot and without assistive devices or orthoses, which may not reflect how patients move in real-world conditions with their usual aids. The sample size was small (59 participants), and cluster sizes were uneven (22, 19, 10, and 8), which may affect the stability of the comparisons. Muscle activity (EMG) was not measured, so the specific muscular causes of the observed kinematic asymmetries remain unclear. This was a cross-sectional study, so it describes associations between subtypes and clinical measures but does not prove that specific interventions will change these subtypes.
Declared interests
The research was supported by JSPS KAKENHI Grant Number 23K27941. No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume that patients with the same walking speed and motor score have the same gait problem. The study found that patients with moderate impairment split into two distinct subtypes with different symmetry deficits and different associated trunk or propulsion issues, meaning a 'one-size-fits-all' approach to gait rehabilitation may miss the specific driver of their asymmetry.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →