Abstract: BACKGROUND: Quantifying the gait features of hemiplegic patients with cerebral infarction can be used as an important reference for their rehabilitation, and the RSSCAN gait system can collect gait parameters quantitatively and timely during walking.
OBJECTIVE: To explore the gait characteristics of hemiplegic patients with cerebral infarction and the difference between affected and unaffected feet.
METHODS: A total of 134 hemiplegic patients with cerebral infarction were selected, including 102 males and 32 females, aged (60±9) years. The gait parameters were collected by the RSSCAN gait system when the patients walked. Clear footprints of the two continually gait cycles of mid-gaits were selected, meanwhile each foot was manually divided into 10 plantar regions: the first toe, the second to fifth toes, the first to fifth metatarsals, the midfoot, the medial heel, and the lateral heel. Then the temporo-spatial parameters and biomechanical parameters were analyzed.
RESULTS AND CONCLUSION: Temporo-spatial gait parameters: compared with the unaffected foot, the affected foot showed shorter stance phase time (P < 0.01) and longer swing phase time and step length (P < 0.05). Pearson or Spearman rank correlation analysis showed that the stance phase time, gait cycle, step length, stride width, and stride were significantly positively correlated between the affected and unaffected feet (P < 0.01). Biomechanical parameters: Compared with the affected foot, the maximum force, maximum pressure and plantar impulse of the healthy foot increased in the first toe, the second to fifth toes and the first metatarsal (P < 0.05), the maximum force in the lateral heel area increased (P < 0.05), the plantar impulse in the medial and lateral heel areas increased (P < 0.01), and the plantar contact area of the second to fifth toes and the midfoot increased (P < 0.05). Pearson or Spearman rank correlation analysis showed that there was a significant positive correlation between the maximum force, maximum pressure and plantar impulse in the 10 plantar regions of the unaffected foot and the affected foot (P < 0.01); and there was a significant positive correlation between the plantar contact area of the second to fifth toes, the first metatarsal, the 2nd metatarsal, the 3rd metatarsal, the 4th metatarsal, the midfoot, the medial heel, and the lateral heel of the unaffected foot and the affected foot (P ≤ 0.01). The gait characteristics of hemiplegic patients with cerebral infarction: in terms of temporal parameters, the unaffected foot plays the main compensatory role; in terms of spatial parameters, the unaffected foot is more conservative than the affected foot to maintain the stability of walking; in terms of biomechanical parameters, the force in the forefoot area of the unaffected foot increases to compensate for the lack of forward propulsion of the affected foot. This compensatory mode of asymmetric force may not be conducive to the recovery of walking ability.

Key words: cerebral infarction, hemiplegia, RSSCAN gait system, gait analysis, temporo-spatial parameter, gait characteristics