Fumihiro Matsuda, RPT, MS, Masahiko Mukaino, MD, DMSc, Kei Ohtsuka, RPT, DMSc,
Hiroki Tanikawa, RPT, DMSc, Kazuhiro Tsuchiyama, RPT, Toshio Teranishi, RPT, DMSc,
Yoshikiyo Kanada, RPT, DMSc, Hitoshi Kagaya, MD, DMSc, Eiichi Saitoh, MD, DMSc
Jpn J Compr Rehabil Sci 7: 111-118, 2016
Objective: The purpose of this study was to analyze
the extent to which lower limb shortening and
compensatory movements contribute to toe clearance
during swing, and to identify the different strategies
employed by healthy individuals and hemiplegic
stroke patients to achieve toe clearance.
Methods: The subjects comprised 18 hemiplegic
stroke patients and 18 healthy individuals matched for
age, gender, and walking speed. We calculated toe
clearance and its components for comparison between
the two groups. We also calculated the correlations
between the components.
Results: The foot-to-floor distance during mid-swing
was smaller in hemiplegic stroke patients than in
healthy individuals. Regarding the components,
shortening of hip-toe length (SHTL) was smaller in
stroke patients, whereas upward movement of the hip
due to pelvic obliquity, upward movement of the foot
due to abduction, and upward movement of the
contralateral hip were all greater. Among hemiplegic
stroke patients, there were significant negative
correlations between SHTL and the other components.
Conclusions: Hemiplegic stroke patients achieved
smaller upward movement by lower limb shortening
compared with healthy individuals. The contribution
of hip hiking and other compensatory movements that
correlated to SHTL appeared to be important in
achieving toe clearance.
Key words: hemiplegia, toe clearance, compensatory movement, gait analysis