A Longitudinal Study of Physical Function Factors Related to Lower Limb Circumduction During Gait in Acute Stroke...

Circumduction gait in stroke patients, a compensatory movement involving pelvic hike and femoral abduction, increases energy cost. However, longitudinal studies on its mechanism during the acute phase are lacking. This study longitudinally investigated changes in the paretic femoral abduction angle during gait in acute stroke patients and identified related factors. Twenty-two stroke patients were assessed twice: at gait initiation and 10-14 days later. Gait kinematics during a 3 m walk were measured using a depth sensor, and physical functions (SIAS) were evaluated. Changes were analyzed using paired t-tests and correlation analyses. Spatiotemporal parameters improved significantly. Kinematically, paretic femoral abduction (p = 0.049) and paretic pelvic hike (p = 0.025) significantly decreased, while maximum paretic knee flexion during swing (p = 0.026) increased. The decrease in femoral abduction correlated positively with the decrease in pelvic hike (r = 0.55) and negatively with the improvement in paretic ankle motor function (SIAS) (ρ = -0.49). The decrease in pelvic hike correlated negatively with the improvement in paretic knee motor function (SIAS) (ρ = -0.43). These results suggest that in acute stroke patients, the recovery of paretic ankle and knee motor functions leads to a reduction in compensatory femoral abduction and pelvic hike, respectively. This study provides insights for re-evaluating compensatory movements as an adaptive phenomenon during recovery, not merely as abnormal movements.