Hemiplegic gait of stroke patients: The effect of using a cane

Objective: To assess the effects of cane use on the hemiplegic gait of stro ke patients, focusing on the temporal, spatial, and kinematic variables. Design: Case-control study comparing the effect of walking with and without a cane using a six-camera computerized motion analysis system. Setting: Stroke clinic of a tertiary care hospital. Participants: Fifteen ambulatory stroke patients were analyzed, including 1 0 men and 5 women (mean age, 56.9 years; mean time since stroke, 9.8 weeks) . Nine age-matched healthy elderly subjects were recruited as a control gro up. Results: Stroke patients walking with a cane showed significantly increased stride period, stride length, and affected side step length, as well as de creased cadence and step width (p < .05) in comparison with those who walke d without a cane. There were no significant differences in the gait phases and the five gait events of hemiplegic gait walking with or without a cane. Cane use thus may have more effect on spatial variables than on temporal v ariables. The affected-side kinematics of hemiplegic gait with a cane showe d increased pelvic obliquity, hip abduction, and ankle eversion during term inal stance phase; increased hip extension, knee extension, and ankle plant ar-flexion during preswing phase; and increased hip adduction, knee flexion , and ankledorsiflexion during swing phase as compared with hemiplegic gait without a cane. A cane thus improved the hemiplegic gait by assisting the affected limb to smoothly shift the center of body mass toward the sound li mb and to enhance push off during preswing phase. It also improved circumdu ction gait during swing phase. Conclusion: Stroke patients walking with a cane demonstrated more normal sp atial variables and joint motion than did those without a cane. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.