Gait analysis system for assessing abnormal patterns in individuals with hemiparetic stroke during robot-assisted gait training: a criterion-related validity study in healthy adults

摘要

Introduction: Gait robots have the potential to analyze gait characteristics during gait training using mounted sensors in addition to robotic assistance of the individual's movements. However, no systems have been proposed to analyze gait performance during robot-assisted gait training. Our newly developed gait robot," Welwalk WW-2000 (WW-2000)" is equipped with a gait analysis system to analyze abnormal gait patterns during robot-assisted gait training. We previously investigated the validity of the index values for the nine abnormal gait patterns. Here, we proposed new index values for four abnormal gait patterns, which are anterior trunk tilt, excessive trunk shifts over the affected side, excessive knee joint flexion, and swing difficulty; we investigated the criterion validity of the WW-2000 gait analysis system in healthy adults for these new index values. Methods: Twelve healthy participants simulated four abnormal gait patterns manifested in individuals with hemiparetic stroke while wearing the robot. Each participant was instructed to perform 16 gait trials, with four grades of severity for each of the four abnormal gait patterns. Twenty strides were recorded for each gait trial using a gait analysis system in the WW-2000 and video cameras. Abnormal gait patterns were assessed using the two parameters: the index values calculated for each stride from the WW-2000 gait analysis system, and assessor's severity scores for each stride. The correlation of the index values between the two methods was evaluated using the Spearman rank correlation coefficient for each gait pattern in each participant. Results: The median (minimum to maximum) values of Spearman rank correlation coefficient among the 12 participants between the index value calculated using the WW-2000 gait analysis system and the assessor's severity scores for anterior trunk tilt, excessive trunk shifts over the affected side, excessive knee joint flexion, and swing difficulty were 0.892 (0.749-0.969), 0.859 (0.439-0.923), 0.920 (0.738-0.969), and 0.681 (0.391-0.889), respectively. Discussion: The WW-2000 gait analysis system captured four new abnormal gait patterns observed in individuals with hemiparetic stroke with high validity, in addition to nine previously validated abnormal gait patterns. Assessing abnormal gait patterns is important as improving them contributes to stroke rehabilitation. Clinical trial registration: https://jrct.niph.go.jp, identifier jRCT 042190109.