Biomechanical Analyses of Gait and Balance in Patients with Subacute Stroke

Abstract Objective: People with stroke may have balance and gait disturbances due to decreased muscle strength and loss of proprioception. Although previous studies have evaluated balance, walking ability, and functional status of people with stroke, studies that quantitatively evaluate these problems and clarify the correlation between each parameter are insufficient. The purpose of this study was to measure the biomechanical gait parameters of subacute stroke patients and investigate their association with balance and function.Method: A cross-sectional study was conducted on patients admitted with stroke as the main diagnosis between November 2020 and November 2021. Functional evaluation was performed using the Korean version of the Modified Barthel Index and the Short Physical Performance Battery; balance was evaluated using Berg balance scale, Trunk Control Test, and Trunk Impairment Scale. Quantitative gait parameters were measured using the Zebris gait analysis system. Bilateral hand grip strength, and bilateral knee extension and flexion strength were measured using a dynamometer. The correlation between each evaluation item was analyzed using Spearman’s correlation analysis.Results: Analysis confirmed a strong positive correlation between the Korean version of the Modified Barthel Index and the Short Physical Performance Battery, indicators of functional status, and Berg balance scale, Trunk Control Test, and Trunk Impairment Scale, indicators of balance. Grip, knee extension, and knee flexion strength of the hemiplegic side were positively correlated with overall balance and functional status. The hemiplegic side showed a shorter stance phase and a longer swing phase, and these values showed a significant correlation with functional status. Step length, step time, and gait line length were significantly correlated with balance.Conclusion: It may be helpful to focus on measuring and correcting the center of pressure and stance phase of the hemiplegic side during gait for balance and functional status improvements. Quantitative biomechanical gait analysis may be helpful in assessing balance and functional status in patients with subacute stroke.