Gait Symmetry Assessment with a Low Back 3D Accelerometer in Post-Stroke Patients

Gait asymmetry is an important marker of mobility impairment post stroke. This study proposes a new gait symmetry index (GSI) to quantify gait symmetry with one 3D accelerometer at L3 (GSI(L3)). GSI(L3) was evaluated with 16 post stroke patients and nine healthy controls in the Six-Minute-Walk-Test (6-MWT). Discriminative power was evaluated with Wilcoxon test and the effect size (ES) was computed with Cliff’s Delta. GSI(L3) estimated during the entire 6-MWT and during a short segment straight walk (GSI(L3straight)) have comparable effect size to one another (ES = 0.89, p < 0.001) and to the symmetry indices derived from feet sensors (|ES| = [0.22, 0.89]). Furthermore, while none of the indices derived from feet sensors showed significant differences between post stroke patients walking with a cane compared to those able to walk without, GSI(L3) was able to discriminate between these two groups with a significantly lower value in the group using a cane (ES = 0.70, p = 0.02). In addition, GSI(L3) was strongly associated with several symmetry indices measured by feet sensors during the straight walking cycles (Spearman correlation: |ρ| = [0.82, 0.88], p < 0.05). The proposed index can be a reliable and cost-efficient post stroke gait symmetry assessment with implications for research and clinical practice.