Pelvic excursion during walking post-stroke: A novel classification system.

Area of Science:

• Biomechanics
• Neurology
• Rehabilitation Science

Background:

• Gait speed is commonly used to assess hemiparetic gait dysfunction.
• However, gait speed does not capture unique biomechanical differences in gait dysfunction.

Purpose of the Study:

• To introduce a novel classification of hemiparetic gait dysfunction using biomechanical pelvic excursion traits.
• To test the hypothesis that greater pelvic excursion deviation correlates with poorer gait characteristics.

Main Methods:

• Compared 41 individuals with post-stroke hemiparesis to 21 controls using an instrumented split-belt treadmill.
• Quantified pelvic excursion in three planes and calculated deviation scores to categorize participants into Type I, II, or III dysfunction.
• Assessed gait asymmetry in kinematics, joint powers, and muscle activity timing.

Main Results:

• Participants with hemiparesis walked at similar self-selected speeds across all groups.
• Classification by pelvic excursion deviation revealed progressive asymmetry in gait kinematics, kinetics, and muscle activity timing.
• Type I, II, and III groups showed progressively greater pelvic excursion deviation.

Conclusions:

• The novel classification effectively categorizes hemiparetic gait dysfunction based on pelvic motion.
• Progressive gait asymmetries indicate that exaggerated pelvic motion significantly contributes to post-stroke gait impairment.
• This biomechanical approach offers a more detailed understanding of gait dysfunction than gait speed alone.