Kinetic and kinematic gait analysis in a spastic hemiplegic patient after selective tibial neurotomy: a case report

ABSTRACT

Kinematics-based studies before and after selective tibial neurotomy (STN) gait have not been performed. It is very important for spastic patients before and after STN to evaluate quality of gait motion. We examined the quantitative changes in kinetic and kinematic parameters in the gait of a hemiplegic patient after STN. A patient with stroke-related hemiplegia who did not require aids to walk underwent a three-dimensional gait analysis (3DGA) before and after STN. 3DGA system was used to obtain spatiotemporal, kinetic and kinematic parameters of the lower extremities. Postoperative increases in walking speed and the single leg support ratio were detected in the paralyzed limb. Kinetic and kinematic analyses of the stance phase performed after STN detected dorsiflexion in the ankle, the appearance of generation power during plantar flexion, an extension of the range of hip movement during the gait cycle, and the disappearance of genu recurvatum. The acquisition of a normalized ankle joint gait pattern after STN might result in coordinated improvements in the kinetic and kinematic parameters of other joints. The measurement of spatiotemporal, kinetic, and kinematic gait parameters using 3DGA systems might aid decisions regarding the optimal post-STN rehabilitation strategies for spastic patients who hope to improve their gaits.