Comparative Efficacy of Open-chain Kinematics and Closed-chain Kinematics on Walking Proficiency and Societal Integration in Post-stroke Individuals: a Pretest- Post-test Experimental Study

Abstract Background Post-stroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residual function. To improve stroke survivors' walking ability, it is necessary to evaluate different rehabilitation approaches and identify those that have a greater effect on locomotor recovery of stroke patients. Objectives This study was designed to compare the effect of open-chain kinematics (bicycle ergometry) and closed-chain kinematics (treadmill) on walking proficiency in post-stroke individuals and their societal integration. Methods This was a pretest- posttest- experimental study involving 35 ambulatory hemiplegic stroke survivors (18males and 17 females) with a mean age of 53.77±10.95 undergoing rehabilitation at the two Teaching Hospitals in Lagos. Patients went through a 10-week rehabilitation and were randomly assigned to two intervention groups. Spatio-temporal gait parameters were measured by the six-metre walkway and community integrated questionnaire was used to examine home integration, social integration and productive activities. Data were subjected to inferential and descriptive statistics. The level of significance was set at p<0.05. Results Results showed significant difference between baseline and post intervention scores for all the gait parameters in the bicycle ergometer group except for stride length (p = 0.078). There was also a significant difference in the mean change in cadence between the treadmill and bicycle ergometer group (p = 0.04). Conclusions Both open-chain and closed-chain kinematics are effective, but closed- chain is most effective in re-educating ambulation and re-gaining spatio-temporal gait parameters after stroke and should be structured into the patients’ treatment regimen to effectively improve functional capability in post-stroke individuals.