Gait in stabilized hemiplegic outpatients in rehabilitation

Hemiplegic patients generally expect an improvement of their gait even at 1 year after stroke. This open and prospective study was addressed to detect even subtle changes in gait characteristics in stabilized patients in rehabilitation treatment by using an opto-electronic system of analysis (ELITE).

Forty-two hemiplegic patients were entered on this study, and mean age was 63.2 years (SD 9.9). The gait measures were obtained four times for each patient; at time of baseline, at the 15th, 30th and 90th day from the beginning of rehabilitation treatment. Plantar flexion moment and ankle joint power were always recorded. Forty healthy volunteers served as controls. Four stride characteristics were examined: duration, length, frequency and speed. ANOVA for repeated measures was used.

In spite of rehabilitation treatment no results in gait were observed after 3 months. A study on patients' expectancy was also done. At the beginning they were given a simple questionnaire along with DSM-IV CISD-1. None of the patients presented with major depression. At admission 38 (90%) patients expected an improvement of the gait. At the end of the rehabilitation treatment, 36 (85%) patients were still confident about therapy and believed in further improvements of their locomotion, whilst six (15%) were dubious.

The study shows discrepancies between objective results and subjective feelings. Psychological factors account for the patients' request of long training periods and alleged favourable outcome.