J Korean Phys Ther.  2022 Dec;34(6):326-331. 10.18857/jkpt.2022.34.6.326.

Gait Recovery Characteristic According to the Injury Aspect of Descending Motor Pathway in a Chronic Stroke Patient: a Case Study

• Yeo SS

• KMID: 2538914
• DOI: http://doi.org/10.18857/jkpt.2022.34.6.326

Abstract

Purpose
The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient.
Methods
One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system.
Results
On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient.
Conclusion
We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

Keyword

Corticospinal tract; Corticoreticular pathway; Vestibulospinal tract; Gait analysis; Diffusion Tensor Imaging