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Gait asymmetry in stroke patients with unilateral spatial neglect

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Abstract

The recovery of independent gait represents one of the main functional goals of the rehabilitative interventions after stroke but it can be hindered by the presence of unilateral spatial neglect (USN). The aim of the paper is to study if the presence of USN in stroke patients affects lower limb gait parameters between the two body sides, differently from what could be expected by the motor impairment alone, and to explore whether USN is associated to specific gait asymmetry. Thirty-five stroke patients (right or left lesion and ischemic or hemorrhagic etiology) who regained independent gait were assessed for global cognitive functioning and USN. All patients underwent a gait analysis session by using a wearable inertial system, kinematic parameters were computed. Enrolled patients presented altered motion parameters. Stroke patients with USN showed specific asymmetries in the following parameters: stance phase, swing phase, and knee range of motion. No differences in the clinical scores were found as the presence of USN. The presence of USN was associated with a specific form of altered gait symmetry. These findings may help clinicians to develop more tailored rehabilitative training to enhance gait efficacy of patients with motor defects complicated by the presence of selected cognitive impairments.

Graphical Abstract

Overview of the experiment setup. The workflow shows: diagnosis of unilateral spatial neglect by the neuropsychologist, sensors placement, gait analysis protocol and evaluation of the gait asymmetry together with the statistically significant features

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to privacy policy but are available from the corresponding author on a reasonable request.

Code availability

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Authors and Affiliations

  1. Department of Neurorehabilitation, Maugeri Institute of Care and Scientific Research, Telese Terme, Campania, Italy

    Pasquale Moretta & Pietro Balbi

  2. Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Campania, Italy

    Leandro Donisi

  3. Department of Bioengineering, Maugeri Institute of Care and Scientific Research, Telese Terme, Campania, Italy

    Leandro Donisi, Giuseppe Cesarelli & Giovanni D’Addio

  4. Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Naples, Campania, Italy

    Giuseppe Cesarelli

  5. Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Campania, Italy

    Luigi Trojano

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  1. Pasquale Moretta
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Contributions

Conceptualization, Pasquale Moretta, Leandro Donisi, and Giovanni D’Addio; methodology, Pasquale Moretta and Leandro Donisi; software, Leandro Donisi; validation, Pietro Balbi and Luigi Trojano; formal analysis, Pasquale Moretta and Leandro Donisi; investigation, Pasquale Moretta, Leandro Donisi and Giovanni D’Addio; resources, Pietro Balbi and Giovanni D’Addio; data curation, Pasquale Moretta, Leandro Donisi and Giuseppe Cesarelli; writing—original draft preparation, Pasquale Moretta and Leandro Donisi.; writing—review and editing, Pietro Balbi, Luigi Trojano and Giovanni D’Addio; visualization, Pasquale Moretta, Leandro Donisi and Giuseppe Cesarelli; supervision, Pietro Balbi, Luigi Trojani and Giovanni D’Addio; project administration, Pietro Balbi and Giovanni D’Addio.

Corresponding author

Correspondence to Leandro Donisi.

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Moretta, P., Donisi, L., Balbi, P. et al. Gait asymmetry in stroke patients with unilateral spatial neglect. Med Biol Eng Comput 61, 651–659 (2023). https://doi.org/10.1007/s11517-022-02738-2

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