Visual Observation Scale for the Upper Limb During Walking in Patients After Stroke.
Condition: Gait, Hemiplegic; Stroke; Upper Extremity Paresis
MeSH terms: Stroke; Paresis; Gait Disorders, Neurologic
Study type: Observational

Summary: 
      For several years now, it has been demonstrated that the upper limb plays an important role
      in the function of an efficient and balanced gait pattern in healthy adults. After a stroke,
      the reduced muscle strength has a clear influence on the gait pattern, but also on the active
      movement possibilities of the upper limb. However, the role of the upper limb during gait is
      not sufficiently explored in the literature. The gold standard for motion analysis is a 3D
      analysis performed with infrared cameras capturing reflective markers during gait.
      Unfortunately, it is not possible for all people after a stroke to undergo this examination.
      On the one hand, patients must already have a certain degree of independence with regard to
      gait. On the other hand, not all centers have access to this expensive accommodation. There
      are some validated observation scales for people after stroke to describe the gait based on a
      2D video image. This method is much more accessible and can be applied by any therapist.
      However, to date there has been little attention paid to the upper limb in these observation
      scales. Therefore, analogous to the observation scales for gait, an observation scale for the
      upper limb during gait was set up. The use of this scale can add value to the rehabilitation
      of people after a stroke.

        -  The treatment team will receive information about the patient's complete movement
           pattern.

        -  The arm will be more prominent when setting rehabilitation goals related to gait. This
           can lead to a positive effect on the gait pattern itself, but also to more attention
           being paid to the arm, which has a more difficult recovery than the leg after a stroke.

      The aim of the current study will be

        -  to determine the inter and intra tester reliability of this visual observation scale

        -  to investigate if the results of the visual observation scale correlate to a 3D
           assessment performed in a subgroup of participants
    

Detailed description: 
      Patients will be walking for 4x10 m. During this walking a 2D video recording in the frontal
      (back and front view) and sagittal plane (left and right sided view) will be performed.

      Supervision of therapist during walking is allowed. Therapist cannot help the patient during
      walking.

      This images will be used to score the visual observation scale (G.A.I.T) and the additional
      observation scale developed for this study.

      In a subgroup of participants from the Ghent University Hospital, a 3D assessment will be
      made on an instrumented treadmill (GRAIL, Motek), which will be used as a golden standard to
      compare with.

      Additional clinical parameters will be investigated to describe the study group.
    

Intervention name(s): Visual observation of arm swing during walking
Intervention type(s): Other
Intervention description(s): The gait pattern of the stroke patients will be scored based on a visual observation scale. Additional components concerning the arm swing have been added to an existing scale.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Stroke patient from inpatient or outpatient rehabilitation centers.
      
Keywords: arm swing; visual observation