Kinematic Biomarkers of Limb Shortening and Compensations in Hemiparetic Gait: A Systematic Review

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BACKGROUND: Hemiparetic gait is characterized by reduced limb shortening during swing, increasing the risk of tripping and leading to compensatory strategies. Despite 3D gait analysis being the gold standard for gait assessment, there is no consensus on relevant kinematic biomarkers for limb shortening and compensatory movements. METHODS: Systematic review querying five databases (PubMed, Cochrane, Scopus, PEDro, and Web of Science). We included articles that described at least one kinematic biomarker of the lower limb in the sagittal plane and at least one biomarker of the lower limb or pelvis in the transversal or frontal plane, or pelvis in the sagittal plane. Then, we collected kinematic biomarkers from these studies and identified those that seemed relevant to describe limb shortening and compensatory movements during the swing phase. RESULTS: We included 40 studies and collected 385 biomarkers. Among them, 15 described limb shortening, 22 compensations, and 3 toe clearance. Analysis of 12 interventional studies showed that some biomarkers of shortening and compensation were more sensitive to change than others. CONCLUSIONS: This review highlights the lack of standardized description for limb shortening and compensatory movements in hemiparetic gait. A set of 13 relevant biomarkers is proposed to improve the interpretation of gait analysis and support consistent evaluation of therapeutic interventions.

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