健常側股関節・膝関節サイクログラムによる片麻痺脳卒中患者の歩行およびバランス評価

Gait disturbances affect mobility and quality of life in patients with post-stroke hemiplegia. While the affected side is traditionally assessed, the evaluation of the unaffected side has remained relatively underexplored. We investigated the potential of the unaffected side's hip-knee cyclogram parameters for assessing gait and balance function in post-stroke patients.

This study included 152 ambulatory patients with post-stroke hemiplegia. Participants underwent instrumented gait analysis and Berg Balance Scale (BBS) assessment. Hip-knee cyclogram parameters were derived from sagittal plane joint angles during gait. Correlations with BBS and leg length-normalized gait speed were analyzed. Subgroup analyses focused on stiff-knee gait and severity of spasticity.

Swing phase area of the unaffected side showed moderately strong correlations with clinical parameters (BBS: ρ=0.66, leg length-normalized gait speed: ρ=0.81) and also correlated with the single-limb support-phase ratio (ρ=0.69) and normalized maximal vertical ground reaction force (ρ=0.60) on the affected side. The unaffected hip-knee cyclogram demonstrated greater consistency across multiple gait cycles, as indicated by a smaller standard deviation and lower variability in joint coordination. In subgroups with stiff-knee gait and severe spasticity, the unaffected side's swing phase area and perimeter demonstrated stronger correlations than those of the affected side.

The hip-knee cyclogram parameters reflected gait function in patients with post-stroke hemiplegia, with the swing phase area of the unaffected side showing stronger correlations with clinical measures and more consistent results.