RESUMEN
This case report describes a woman in her fifties who experienced a left-sided atherothrombotic cerebral infarction with lesions in the left corona radiata. The patient exhibited motor paralysis of the right upper and lower limbs. After a 10-day acute hospital stay, she was admitted to a rehabilitation facility for an intensive program of physical, occupational, and speech therapy. By day 17 of the onset, she had achieved independence by walking with a cane. This case was documented to study the effects of gait training with non-paretic knee immobilization on muscle activity and trunk kinematics in post-stroke hemiplegia. Traditional physical therapy was used initially, followed by an intervention phase in which gait training was performed with the non-paretic knee immobilized. This approach was hypothesized to induce beneficial kinematic and muscle activity changes in the paretic limb. The results showed increased muscle activity in the paretic lateral gastrocnemius without compromising trunk stability, suggesting that this method may improve rehabilitation outcomes in similar cases.
RESUMEN
OBJECTIVE: The purpose of this study was to examine the longitudinal changes in trunk acceleration, gait speed, and paretic leg motion in patients with post-stroke hemiparesis, the relationships between variables at each time point, and whether initial trunk acceleration and gait parameters were related to gait speed 2 months later. METHODS: Gait was assessed monthly in patients who could walk under supervision after stroke onset. Gait parameters, including gait speed and trailing limb angle (TLA), were measured. Trunk acceleration was quantified using acceleration root mean square (RMS) and stride regularity (SR) indices. RESULTS: This study found statistically significant longitudinal changes in gait speed (p < .001), acceleration RMS of the total axes (p < .001), and SR of the vertical axes (p < .001). Gait speed correlated significantly with the acceleration RMS of the mediolateral (r = -0.815 to -0.901), vertical (r = -0.541 to -0.747), and anteroposterior (r = -0.718 to -0.829) axes, as well as the SR of the vertical axes (r = 0.558 to 0.724) at all time points from T0 to T2. For the TLA, only the acceleration RMS of the mediolateral axis correlated significantly over the entire study period (r = -0.530 to -0.724). In addition, initial TLA correlated significantly with gait speed after 2 months (r = -0.572). CONCLUSION: This study showed that assessing trunk acceleration helps estimate the improvement in gait status in patients with post-stroke hemiparesis. The magnitude and regularity of trunk acceleration varied longitudinally and were related to gait speed and paretic leg motion at each time point; however, they could not predict future changes in gait speed.