Gait patterns in ischemic and hemorrhagic post-stroke patients with delayed access to physiotherapy

Abstract

Objectives: (1) To assess the effects of a conventional, delayed physiotherapy protocol used by Ischemic Stroke (IS) and Hemorrhagic Stroke (HS) post-stroke patients, in their electromyographic activation patterns during hemiparetic gait; and (2) to study whether this protocol may improve the functional abilities in this population. Methods: This is an observational, descriptive, and analytical quasi-experimental trial. Forty patients with unilateral IS ([Formula: see text]) and HS ([Formula: see text]) stroke were recruited; the stroke involved the motor cortex or sub-cortical areas, and the patients were able to walk independently. Interventions with standard protocols of physiotherapy were carried out. Evaluations (clinical and gait assessment) were performed at the time of admission and at the end of the protocol. Outcome measures include Stroke Impact Scale, Timed Up and Go Test, and gait electromyographic evaluation. Results: Only IS patients (with an average of [Formula: see text] months delayed access to physiotherapy rehabilitation) had improvements in Timed Up and Go Test (change in [Formula: see text][Formula: see text]seg [Formula: see text]) and presented an anticipation of the onset in Upper leg muscles after the intervention. BF ([Formula: see text]), ST ([Formula: see text]), and RF ([Formula: see text]), started their recruitment (onset) earlier at the swing phase of the gait cycle, which is more similar to the normal pattern (grey shadow). IS and HS ([Formula: see text] months since last stroke) patients presented higher electromyographic activation, after physiotherapy, of the posterior leg muscles (gastrocnemius, semitendinosus and biceps femoris) during stance phase ([Formula: see text]). Conclusion: IS patients had improvements after delayed conventional physiotherapy. For HS limited response to intervention was observed.

A Quantitative Gait Assessment Approach Using a Wearable Device and Its Validation for Different Neurological Disorder Conditions

“…The 1-way analysis of variance (ANOVA)65 test was conducted to analyze the influence of the mean gait values in the subcategory of the specific disease group. For example, within the CVA group, the arterial type leads to motor deficits, compared with the venous type 4,66. Here, the test is applied to check the null hypothesis that there is no significant difference between means of each gait parameter of the pair of disease subgroups.…”

“…For example, within the CVA group, the arterial type leads to motor deficits, compared with the venous type. 4,66 Here, the test is applied to check the null hypothesis that there is no significant difference between means of each gait parameter of the pair of disease subgroups. To examine the simultaneous effect between the subgroups, the MANOVA is used to check the null hypothesis and there is no significant difference between each pair of the disease subgroup.…”

Improvements of mid‐thigh circumferences following robotic rehabilitation in hemiparetic stroke patients

“…It is widely acknowledged that initiating a rehabilitation program from early on would be more advantageous. However, some researchers claim that “late plasticity” of the brain exists, suggesting that even chronic patients have equal chances of recovery (Callegari et al., 2021). Several of the participants had already progressed to chronic stroke, as the onset was more than 6 months.…”

“…Several of the participants had already progressed to chronic stroke, as the onset was more than 6 months. Owing to the late plasticity theory, it is safe to consider that all participants with chronic stroke also have equal potential for recovery (Callegari et al., 2021). The 5‐year cut‐off point in the study was since 60% of stroke patients survive within 5 years after diagnosis, according to the Ministry of Health Malaysia (2021).…”

Gait Analysis of Hemiparetic Adult Patients with a Quadripod Cane and a Rolling Cane

“…In addition, the swing and phase durations of the affected limb are, respectively, longer and shorter than those of the healthy limb [1,7]. Callegri et al conducted a gait analysis study of hemiparetic patients using electromyography [8]. Compared to the normal gait pattern, they observed early co-activation of the tibialis anterior and gastrocnemius muscles in the stance phase of hemiparetic patients [8].…”