2016 Volume 7 Pages 111-118
Matsuda F, Mukaino M, Ohtsuka K, Tanikawa H, Tsuchiyama K, Teranishi T, Kanada Y, Kagaya H, Saitoh E. Analysis of strategies used by hemiplegic stroke patients to achieve toe clearance. Jpn J Compr Rehabil Sci 2016; 7: 111-118.
Objective: The purpose of this study was to analyze the extent to which lower limb shortening and compensatory movements contribute to toe clearance during swing, and to identify the different strategies employed by healthy individuals and hemiplegic stroke patients to achieve toe clearance.
Methods: The subjects comprised 18 hemiplegic stroke patients and 18 healthy individuals matched for age, gender, and walking speed. We calculated toe clearance and its components for comparison between the two groups. We also calculated the correlations between the components.
Results: The foot-to-floor distance during mid-swing was smaller in hemiplegic stroke patients than in healthy individuals. Regarding the components, shortening of hip-toe length (SHTL) was smaller in stroke patients, whereas upward movement of the hip due to pelvic obliquity, upward movement of the foot due to abduction, and upward movement of the contralateral hip were all greater. Among hemiplegic stroke patients, there were significant negative correlations between SHTL and the other components.
Conclusions: Hemiplegic stroke patients achieved smaller upward movement by lower limb shortening compared with healthy individuals. The contribution of hip hiking and other compensatory movements that correlated to SHTL appeared to be important in achieving toe clearance.
