Analysis of gait with a cane in patients with hemiplegia.

Gait with a cane as the aid was analyzed by using a floor reaction force plate in 60 patients (consisting of 23 with Stage III, 14 with Stage IV, 14 with Stage V and 9 with Stage VI, according to Brunnstrom's classification of legs) with hemiplegia due to a cerebrovascular disorder who could walk with the aid. The patients were told to walk on a 1.2m×10.8m gaitway on which four 0.6m×1.8m force plates of the three-component type were placed in juxtaposition and in a mixture, and three-way-oriented components of the respective floor reaction force on the cane and the affected leg were measured. The floor reaction force was quantitatively analyzed for time ratio, impulse, mean force and peak value. Step length, gait velocity, step frequency and step width were also calculated from the locus of the COP. Changes due to the presence or absence of the aid were also studied in 45 patients who could walk without the aid.<br>Of the floor reaction force on the cane, that of the vertical component was the strongest, followed by the lateral (internal) component, the deccelerated one and the accelerated one, in that order. Individual differences in each component of the floor reaction force on the cane tended to be greater than that on the affected leg. When the relationships between the mean force on the cane for the components and the mean force on the affected leg for the components were determined, there were positive correlations between the vertical component, and the individual deccelerated, accelerated and lateral components both in the canes and in the affected legs. There were negative correlations between the force of the vertical component on the canes and of the vertical and accelerated components on the affected legs, showing that the force of the vertical component tended to increase when the affected leg was hypofunctional. None of the forces of the deccelerated, accelerated or lateral components on the canes was correlated with that of any component on the affected leg, and there was no difference due to difference in function of the affected leg and the gait pattern (2-movement gait and 3-movement gait). The force of the vertical and lateral components on the affected leg, the step frequency and the step width in the case of gait without the aid were greater than those in the case of gait with the aid, while step length in the former case was less than that in the latter case. However, there were no changes in the force of the decceleraed or accelerated component on the affected leg.<br>The role of cane in patients with hemiplegia is considered to compensate for decreased support of the affected leg, to shift the center of gravity toward the affected side, and to ensure lateral stability in a smaller step width.