Analysis of spatiotemporal gait parameters and balance in patients with subacute stroke
Abstract
Relevance. Acute cerebrovascular accident is one of the leading causes of persistent disability among adults and is associated with substantial impairments in locomotor function, balance, and functional mobility. During the subacute recovery period, timely identification of abnormalities in spatiotemporal gait parameters and postural control is essential for planning individualised physical therapy programmes. Aim. To comprehensively analyse spatiotemporal gait parameters, balance measures, exercise tolerance, and kinematic characteristics of the locomotor pattern in patients during the subacute period following stroke. Materials and methods. A single-centre cross-sectional observational study was conducted in 60 patients (32 men and 28 women) aged 38-59 years. The 10-metre walk test, 6-minute walk test, Timed Up and Go test, Berg Balance Scale, and Rancho Observational Gait Analysis were used. The distribution was checked by the Shapiro-Wilk criterion; M ± SD and 95% confidence intervals were determined. Associations were assessed using Spearman’s correlation coefficient with bootstrap 95% confidence intervals; sex subgroups were compared using the Mann-Whitney U test; and multiple linear regression was performed. Results. The mean gait speed was 0.55 ± 0.27 m/s (95% CI 0.48-0.62), step length was 0.43 ± 0.10 m, and cadence was 1.27 ± 0.44 steps/s. The 6MWT distance was 292.3 ± 121.5 m; 83.3% of participants walked < 400 m. The TUG time was 23.37 ± 10.20 s; in 51.7%, it exceeded 20 s. The average Berg Score was 31.22 ± 7.98; 93.3% did not reach 45 points. Gait speed correlated with TUG (ρ = -0.889) and Berg (ρ = 0.693), and 6MWT correlated with Berg (ρ = 0.649; all p < 0.001). The regression model explained 66.3% of Berg variations; independent predictors were gait speed (β = 0.569) and 6MWT (β = 0.397; both p < 0.001). No gender differences were found (p > 0.05). Practical significance. The results obtained can be used to individualise physical therapy programmes, determine priority areas for restoring walking, balance, and functional mobility, and to monitor the effectiveness of rehabilitation interventions in patients in the subacute period after stroke.