Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis

Background/Objectives: Post-stroke hemiparetic gait often presents with asymmetric patterns to compensate for stability deficits. This study examines gait differences in chronic stroke patients with spastic hemiparesis based on initial foot contact type—forefoot versus rearfoot. Methods: Thirty-four...

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Main Authors: Inês Mendes-Andrade, Miguel Reis e Silva, Jorge Jacinto
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Neurology International
Subjects:
Online Access:https://www.mdpi.com/2035-8377/17/1/10
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author Inês Mendes-Andrade
Miguel Reis e Silva
Jorge Jacinto
author_facet Inês Mendes-Andrade
Miguel Reis e Silva
Jorge Jacinto
author_sort Inês Mendes-Andrade
collection DOAJ
description Background/Objectives: Post-stroke hemiparetic gait often presents with asymmetric patterns to compensate for stability deficits. This study examines gait differences in chronic stroke patients with spastic hemiparesis based on initial foot contact type—forefoot versus rearfoot. Methods: Thirty-four independently walking spastic hemiparetic patients were retrospectively analyzed. Using 3D gait analysis, patients were categorized by initial contact type. Spatiotemporal descriptors, joint kinematics, kinetics, and EMG patterns were compared across groups. Results: Patients with rearfoot initial contact (G1) showed higher cadence, longer single-limb support time and shorter stride times than those with forefoot contact (G0). G1 patients also demonstrated greater knee flexion during stance, enhancing stability. Additionally, G1 patients with abnormal lateral gastrocnemius activation in the swing phase showed increased ankle power at the end of the stance phase. Conclusions: In post-stroke spastic hemiparetic patients, the type of initial foot contact—forefoot or rearfoot—appears to influence gait characteristics, with rearfoot contact associated with a trend toward improved gait parameters, such as increased cadence and longer single-limb support.
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spelling doaj-art-4251751d7609457f878c21a3a1f759a92025-01-24T13:44:24ZengMDPI AGNeurology International2035-83772025-01-011711010.3390/neurolint17010010Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait AnalysisInês Mendes-Andrade0Miguel Reis e Silva1Jorge Jacinto2Laboratório de Marcha, Centro de Medicina de Reabilitação de Alcoitão, 2649-506 Alcabideche, PortugalLaboratório de Marcha, Centro de Medicina de Reabilitação de Alcoitão, 2649-506 Alcabideche, PortugalLaboratório de Marcha, Centro de Medicina de Reabilitação de Alcoitão, 2649-506 Alcabideche, PortugalBackground/Objectives: Post-stroke hemiparetic gait often presents with asymmetric patterns to compensate for stability deficits. This study examines gait differences in chronic stroke patients with spastic hemiparesis based on initial foot contact type—forefoot versus rearfoot. Methods: Thirty-four independently walking spastic hemiparetic patients were retrospectively analyzed. Using 3D gait analysis, patients were categorized by initial contact type. Spatiotemporal descriptors, joint kinematics, kinetics, and EMG patterns were compared across groups. Results: Patients with rearfoot initial contact (G1) showed higher cadence, longer single-limb support time and shorter stride times than those with forefoot contact (G0). G1 patients also demonstrated greater knee flexion during stance, enhancing stability. Additionally, G1 patients with abnormal lateral gastrocnemius activation in the swing phase showed increased ankle power at the end of the stance phase. Conclusions: In post-stroke spastic hemiparetic patients, the type of initial foot contact—forefoot or rearfoot—appears to influence gait characteristics, with rearfoot contact associated with a trend toward improved gait parameters, such as increased cadence and longer single-limb support.https://www.mdpi.com/2035-8377/17/1/10gait analysisstrokespasticity
spellingShingle Inês Mendes-Andrade
Miguel Reis e Silva
Jorge Jacinto
Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
Neurology International
gait analysis
stroke
spasticity
title Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
title_full Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
title_fullStr Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
title_full_unstemmed Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
title_short Initial Contact with Forefoot or Rearfoot in Spastic Patients After Stroke—Three-Dimensional Gait Analysis
title_sort initial contact with forefoot or rearfoot in spastic patients after stroke three dimensional gait analysis
topic gait analysis
stroke
spasticity
url https://www.mdpi.com/2035-8377/17/1/10
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AT miguelreisesilva initialcontactwithforefootorrearfootinspasticpatientsafterstrokethreedimensionalgaitanalysis
AT jorgejacinto initialcontactwithforefootorrearfootinspasticpatientsafterstrokethreedimensionalgaitanalysis