Abstract
Depression is the most prevalent emotional disorder among post-stroke patients and may influence gait recovery and movement patterns. However, scarce prior research has specifically examined the biomechanical differences in gait between stroke patients with and without depression. This study aimed to explore variations in lower extremity biomechanical parameters during gait based on depression status. A prospective observational design was employed, recruiting 20 chronic stroke patients (post-onset > 6 months) and 10 healthy persons. The Geriatric Depression Scale classified stroke patients into a depressed group (n = 10) and a non-depressed group (n = 10). Participants walked along a seven-meter walkway while a 3D motion analysis system captured sagittal plane biomechanical data from the bilateral hip, knee, and ankle joints. Group differences were analyzed using the Kruskal-Wallis test, with Mann-Whitney post-hoc comparisons. Findings revealed that the non-depressed group exhibited significantly greater peak generation power at the unaffected hip compared to the depressed group (p = 0.019). Additionally, both stroke groups demonstrated significantly lower peak ankle generation power and reduced maximum knee flexion on the unaffected side compared to the healthy group (p < 0.05). These results suggest that post-stroke gait biomechanics could be different according to psychological factors, emphasizing the need for tailored therapy in the latter rehabilitation period. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-40475-w.