Gait in hemiplegia: evaluation of clinical features with the Wisconsin Gait Scale

To assess the ability of the Wisconsin Gait Scale to evaluate qualitative features of changes in hemiplegic gait in post-stroke patients. A prospective observational study. Ten healthy subjects and 56 hemiplegic outpatients, more than 12 months post-stroke, consecutively admitted in a rehabilitation centre. Patients were videotaped while walking at a comfortable speed. Quantitative and clinical gait parameters were derived from videotaped walking tasks at admission and at the end of a period of rehabilitation training. Qualitative features were assessed using the Wisconsin Gait Scale. Functional status was rated through the modified Barthel Index. After training, the median Wisconsin Gait Scale score improved significantly (28 vs 26.5; p = 0.003). In particular, "weight shift to paretic side" and patterns during the swing phase of the affected leg were improved. Gait velocity (0.3 vs 0.4 m/sec; p = 0.001) and stride length (77 vs 85 cm; p = 0.0002) increased significantly, whereas number of steps (25 vs 23; p = 0.004), stride period (2.5 vs 2.3 sec; p = 0.04), and stance period (2.1 vs 2 sec; p = 0.03) of the unaffected side were reduced. The Barthel Index score increased (71 vs 78; p = 0.005). The Wisconsin Gait Scale is a useful tool to rate qualitative gait alterations of post-stroke hemiplegic subjects and to assess changes over time during rehabilitation training. It may be used when a targeted and standardized characterization of hemiplegic gait is needed for tailoring rehabilitation and monitoring results.