Quantitative Assessment of Gait During Rehabilitation Using an Instrumented Treadmill

Kinetic gait analysis of subacute stroke is a relatively unexplored area of study. Chronic stroke literature on the subject is extensive but does not capture the time period where the extent of recovery is greatest. Translating methods of gait analysis seen in research to a clinical setting is subject to many additional requirements which have previously prevented such investigations. The work presented in this thesis represents the first investigation using NeuroRecoVR, a new instrumented treadmill facility located within an inpatient rehabilitation gym. Working directly with inpatient physiotherapists, this study examines kinetic based gait parameters to quantify levels of impairment in subacute stroke. Recovery is most readily seen in changes in the walking speed of an individual, with many other gait parameters changing alongside walking speed. Therefor the relationships for all parameters of interest to walking speed are investigated in both neurologically intact controls (n = 14) and those undergoing rehabilitation for subacute stroke (n = 15). Parameters including spatiotemporal measures, forces, impulses, center of mass trajectory, center of pressure variability, and measures of symmetry were calculated for both groups. Subacute stroke participants have higher levels of asymmetry, increased instability, and altered gait dynamics compared to neurologically intact controls. The extent of recovery for each parameter was examined in a subset of stroke patients who took part in instrumented treadmill training over 1-2 months of rehabilitation (n = 4; mean ±SD age = 65 ±17; mean ±SD days post stroke at first session = 79 ±67). These participants showed improvements in stability, walking speed, and symmetry over the course of rehabilitation. These results show the benefit and potential for the use of kinetic analysis for aspects of both research and rehabilitatio