A Longitudinal Study of Physical Function Factors Related to Lower Limb Circumduction During Gait in Acute Stroke Patients with Hemiparesis

Circumduction gait in stroke patients, a compensatory movement involving pelvic hike and femoral abduction, increases energy cost. However, longitudinal studies on its mechanism during the acute phase are lacking. This study longitudinally investigated changes in the paretic femoral abduction angle during gait in acute stroke patients and identified related factors. Twenty-two acute stroke patients were assessed twice: at gait in-itiation and 10-14 days later. Gait kinematics during a 3m walk were measured using a depth sensor, and physical functions (SIAS) were evaluated. Changes were analyzed us-ing paired t-tests and correlation analyses. Spatiotemporal parameters improved signifi-cantly. Kinematically, paretic femoral abduction (p = 0.049) and paretic pelvic hike (p = 0.025) significantly decreased, while maximum paretic knee flexion during swing (p = 0.026) increased. The decrease in femoral abduction correlated positively with the de-crease in pelvic hike (r=0.55) and negatively with the improvement in paretic ankle motor function (SIAS) (ρ=-0.49). The decrease in pelvic hike correlated negatively with the im-provement in paretic knee motor function (SIAS) (ρ=-0.43). These results suggest that in acute stroke patients, the recovery of paretic ankle and knee motor functions leads to a re-duction in compensatory femoral abduction and pelvic hike, respectively. This study pro-vides insights for re-evaluating compensatory movements as an adaptive phenomenon during recovery, not merely as abnormal movements.