Abstract
RATIONALE: In poststroke patients with hemiplegia, gait disorders often remain as a sequela. Although gait analysis commonly focuses on lower limb dysfunction, there is limited evidence addressing the contribution of upper limb movement to gait improvement after stroke. A 3D optical motion analysis is commonly used to treat gait disorders, as it allows precise assessment of gait disorders by measuring joint range of motion, stride length, and time. However, these require multiple cameras and sensors, making the setup time-consuming. In this case, we conducted gait analysis using a newly introduced and easier-to-use suit-type wearable device (STWD) before and after rehabilitation therapy in a chronic posthemorrhagic stroke patient. PATIENT CONCERNS: An 82-year-old Japanese man with right hemiplegia and gait disorder due to left midbrain hemorrhage was referred to our hospital for rehabilitation therapy. DIAGNOSES: By using STWD, we determined that his gait disorder was mainly due to right upper limb hemiplegia, as STWD showed that the right shoulder flexion angle during gait was very limited. INTERVENTIONS: We performed botulinum toxin type A therapy and repetitive transcranial magnetic stimulation for the upper limb, as well as physical and occupational therapy for upper limb and gait disorders. OUTCOMES: Right shoulder flexion angle during gait, upper limb function assessed by Fugl-Meyer Assessment, and gait function assessed by Timed Up and Go test all improved. Each STWD session took about 2 to 3 minutes to set up. LESSONS: When treating gait disorders, we should not only look at the patients' lower limb function but also their upper limb function as well. STWD is more convenient than the conventional 3-dimensional optical motion analysis, allowing for quick and less burdensome measurements. Its application in various scenarios is anticipated.