Observation and analysis of hemiplegic gait: stance phase

People with hemiplegia resulting from cerebrovascular accident commonly demonstrate one or more deviations from the kinematics of normal gait. This paper presents a list of common kinematic deviations for which physiotherapists might look when making clinical observations of hemiplegic gait. A number of likely causes of those kinematic deviations are described, based on a review of the literature, biomechanical considerations and clinical observations. Particularly common and significant stance phase deviations are a decreased peak hip extension in late stance, increased or decreased peak lateral pelvic displacement, increased or decreased knee extension in early or mid stance and decreased plantarflexion at toe-off. The causes of these kinematic deviations lie in the inability to appropriately activate muscles and in the adaptive muscle shortening which commonly occurs following stroke.