The Impact of Upper Limb Functioning on Gait Patterns in Individuals with Post-Stroke Hemiplegia

Abstract

Hemiplegia resulting from a stroke leads to a distinct gait pattern and dysfunction in the upper limb. The objective of this study was to determine a correlation between the functionality of the upper limb and selected spatiotemporal parameters of gait in patients with hemiplegia following a stroke. The study comprised a sample of 80 outpatients (45 males and 35 females) with post-stroke hemiplegia, with an average age of 60.78 years, selected using a convenient sampling method. To assess the functionality of the affected upper limb, the study employed the QuickDASH questionnaire, which is a shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire. Concurrently, the participants were recorded on video while performing the 4-meter walk test (4mWT). The recorded videos were meticulously analyzed using Kinovea software (version 0.8.15) to calculate gait parameters such as comfortable and maximum speeds, stride length and time  on the paretic and affected side, number of steps taken to cover the 4m, and cadence. Pearson Correlation analysis was conducted to explore potential associations between these gait parameters and the QuickDASH score, with a significance level of p < 0.05. The findings revealed significant correlations between upper limb functionality and selected gait parameters. Reduced upper limb functionality correlated with decreased comfortable speed (p < 0.05), maximum speed (p < 0.05), and cadence (p < 0.05) during the 4mWT. In contrast, impaired upper limb function linked to prolonged time to complete the 4m distance (p < 0.05), increased steps taken by both affected (p < 0.05) and unaffected (p < 0.05) sides, and extended stride time on both sides (p < 0.05). However, no substantial correlation emerged between upper limb functionality and stride length on either side (p > 0.05). In conclusion, this study emphasizes the correlation between upper limb functionality and specific gait parameters in post-stroke hemiplegic patients. The correlation between upper limb functionality and selected spatiotemporal parameters of gait underscores the necessity for integrated rehabilitation strategies targeting both upper limb and gait training. These findings contribute to a deeper comprehension of the connection between upper limb disability and gait parameters, emphasizing the significance of personalized treatments in order to maximize the restoration of functionality in individuals who have suffered a stroke.