[A relationship between the movement pattern and lesion location in the early rehabilitation period after ischemic stroke].

Unlabelled: To study the changes in movement pattern during the early rehabilitation period in patients after carotid/vertebro-basilar ischemic stroke.

Material And Methods: The authors studied 11 patients (6 women, 5 men, mean age 57.2±5.2) 4-6 weeks after stroke onset. NIHSS on admission was 6.2±0.8, arm/hand weakness 3.9±0.7/3.7±0.8, leg/foot weakness 4.3±0.6/4.0±0.5. The lesion was located in the carotid artery (7 patients) and in the vertebro-basilar system (4 patients). All patients were examined on admission and at discharge (interval 13±4 days). The changes were assessed using FIM scale, Ashwort scale, TUG test, nine-hole peg test (NHPT), Berg balance scale, 20-point vestibular disorder score scale, MMSE, Beck depression inventory, and Spielberger anxiety questionnaire. Also kinematic and kinetic profiles of the step cycle and gait were analyzed by video analysis system Physiomed Smart (Physiomed, Germany, Davis protocol).

Results: All patients demonstrated improvement in FIM scale, Ashwort scale, TUG test, NHP test, Berg balance scale and 20-point vestibular disorder score scale. Patients with vertebro-basilar stroke had balance disturbance, which was assessed with 20-point vestibular disorder score scale. All patients had changes in spatiotemporal gait performance, kinematic and kinetic profiles of the walking cycle: shortening of the step length and widening of the step width, prolongation of step cycle, and decreased step speed. These changes were more obvious in patients with vertebro-basilar stroke. Also patients with vertebro-basilar stroke had pelvic tilt forward, while patients with carotid lesion had pelvic obliquity.

Conclusion: Lesion location in patients with mild stroke may influence the spatiotemporal gait characteristics and kinematic and kinetic profiles. These features should be taken into account while planning rehabilitation strategy.