# CLINICAL ASSESSMENTS AND GAIT CHARACTERISTICS BY SUBTYPE CLASSIFICATION USING TEMPORAL AND KINEMATIC SYMMETRY INDICES DURING GAIT IN PATIENTS WITH CHRONIC STROKE

## TL;DR

This study identifies four distinct walking patterns in stroke patients based on leg movement symmetry, which could help tailor rehabilitation.

## Contribution

The study introduces a novel clustering approach to classify gait subtypes using temporal and kinematic symmetry indices in chronic stroke patients.

## Key findings

- Four subtypes of gait symmetry were identified in chronic stroke patients.
- Subtypes with high kinematic symmetry showed moderate motor paralysis and high paretic-side propulsion.
- Subtypes with high temporal symmetry had higher muscle tone and lower paretic-side propulsion.

## Abstract

Gait symmetry is an important assessment indicator in patients with stroke and is classified into temporal and kinematic types. This study aimed to clarify the clinical assessments and ability characteristics of subtypes by gait symmetry through clustering analysis using symmetry indices.

Retrospective, cross-sectional, observational study.

Fifty-nine patients with chronic stroke who could walk independently without aids during measurement, including those who habitually used an assistive device.

Gait was analysed with a 3-dimensional motion analysis system and force plates. Temporal symmetry was assessed using the swing-time ratio; kinematic symmetry was assessed by the normalized cross-correlation of left–right knee angle waveforms; k-means clustering used the 2 indices; and clinical measures and comfortable gait speed were compared across subtypes.

Four subtypes were identified. Subtypes with high kinematic but low temporal symmetry had moderate motor paralysis, moderate gait speed, and high paretic-side propulsion, whereas subtypes with high temporal but low kinematic symmetry showed moderate motor paralysis, higher muscle tone, moderate gait speed, and lower paretic-side propulsion.

This study provides new insights into gait symmetry in stroke and may help lay the groundwork for future studies on gait classification and rehabilitation.

Many people who have had a stroke have difficulty walking, often because one leg moves differently from the other. This study examined 59 people with chronic stroke to better understand these differences. We used a walking test to measure how similar the timing and movement of the legs were during walking. Based on these measurements, we identified 4 distinct types of walking patterns. Some individuals showed movements that were quite similar on both sides, but still walked slowly, whereas others walked faster, but had greater differences between the 2 legs. These differences were also associated with other issues, such as muscle stiffness and weakness. Understanding these walking patterns can help therapists select more appropriate exercises for each person. By tailoring rehabilitation to the specific type of walking problem, we hope to improve walking ability and increase independence in daily life.