Foot contact pattern analysis in hemiplegic stroke patients: An implication for neurologic status determination

Wong AM, Pei Y-C, Hong W-H, Chung C-Y, Lau Y-C, Chen CP. Foot contact pattern analysis in hemiplegic stroke patients: an implication for neurologic status determination. Arch Phys Med Rehabil 2004;85:1625-30. Objective To investigate the feasibility of using a foot contact pattern to predict neurologic recovery and the effect of ambulation training in hemiplegic stroke patients. Design Case-comparison study. Setting Gait laboratory in a tertiary care center. Participants Sixty-five functionally ambulant hemiplegic stroke patients, and 30 healthy subjects serving as the control group. Interventions Gait analyses were performed by using the conventional gait analysis system (6 cameras) and the portable Computer DynoGraphy (CDG) system. Main outcome measures Walking velocity, step length, and cadence were measured from the conventional gait analysis system. Cyclogram, gaitline, and ground reaction force (GRF) patterns were recorded with the CDG system. Results Velocity, cadence, and step length increased in higher Brunnstrom stages (P<.01). Negative correlation was noted between the Brunnstrom stages and the foot contact patterns (P<.01). Lower cyclogram, GRF, and gaitline patterns were expected in subjects with higher Brunnstrom stages. There were high prediction probabilities between cyclogram, gaitline, and GRF patterns. Conclusions Foot contact pattern can be a simple and reliable indicator of hemiplegic gait in stroke patients. It is closely related to patient's neurologic status and is correlated with parameters obtained from conventional gait analysis systems. Pathologic presentations are noted in both the affected and unaffected limbs, suggesting that rehabilitation programs should be implemented on both sides.