Gait patterns in ischemic and hemorrhagic post-stroke patients with delayed access to physiotherapy.
Bianca Callegari, Daniela Rosa Garcez, Alex Tadeu Viana da Cruz Júnior and 8 others
PMID 34177196WHAT IT FOUND
Chronic stroke patients waiting for physiotherapy showed different recovery patterns based on stroke type.
Ischemic stroke patients improved walking speed and muscle timing, but hemorrhagic patients showed little change. Neither group reported improved quality of life, suggesting late treatment has limited functional gains.
Key findings
01Ischemic stroke patients improved their Timed Up and Go test scores after physiotherapy, while hemorrhagic stroke patients did not.
02Ischemic stroke patients showed earlier muscle activation in the swing phase, moving closer to normal gait patterns, whereas hemorrhagic patients showed no such changes.
03There was no significant difference in Stroke Impact Scale scores between groups or before and after treatment for either stroke type.
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 had a small sample size, particularly for the hemorrhagic stroke group (n=15), which may affect the reliability of findings for this population. Only five muscles on the paretic limb were assessed due to equipment constraints, limiting the view of overall gait mechanics. The standard physiotherapy protocol was not controlled by the researchers, introducing variability in treatment delivery. The Stroke Impact Scale may not be sensitive enough to detect subtle neurological or functional recoveries in chronic patients.
Declared interests
The authors declare no competing interests. The study was supported by public research grants (FAPESPA, CAPES/COFECUBE, UFPA) with no role for funders in design or analysis.
The easy way to misread this
Do not assume that late physiotherapy is ineffective for chronic stroke patients. While quality of life scores did not improve, ischemic stroke patients did show measurable improvements in walking speed and muscle timing. Conversely, do not generalize these gains to hemorrhagic stroke patients, who showed little neuromuscular change in this study.