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Analysis of Gait in Stroke Patients with Hemiplegia Using a Wearable Accelerometer

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Background : Restoration of walking ability is the major goal of rehabilitation for stroke patients with hemiplegia. However, assessment methods are based on subjective evaluation, and no established objective assessment method exists that is clinically feasible. This study aimed to determine whether accelerometers could be used as clinically feasible objective assessment tools for predicting walking ability in stroke patients with hemiplegia. / Methods : Participants included 36 stroke patients with hemiplegia who were able to walk (group C) and 40 healthy individuals (group N). Wearable accelerometers were attached at the seventh cervical (C7) and third lumbar vertebral (L3) levels. Acceleration, in three axial directions (mediolateral, vertical, and anteroposterior), was measured during walking. Root mean square values were calculated and used as indices for cervical and lumbar sway. Associations between these values and the degree of gait independence, measured using the Functional Ambulation Classification (FAC) score, were evaluated. / Results : The cervical/lumbar sway significantly increased with decreasing degrees of gait independence (from groups with FAC5 to FAC4 and FAC3) in all three directions in group C. In group N, the cervical sway was smaller than the lumbar sway in all three directions. In group C, the cervical sway increased with decreasing degrees of gait independence; however, in the group with FAC3, the cervical sway was greater than the lumbar sway, showing a reverse phenomenon. / Conclusions : These results revealed an association between body sway and degree of gait independence and demonstrated that evaluating cervical/lumbar sway using wearable accelerometers helped accurately and objectively assess walking ability.

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