{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T06:00:33Z","timestamp":1776837633397,"version":"3.51.2"},"reference-count":38,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003665","name":"National IT industry Promotion Agency","doi-asserted-by":"publisher","award":["S0316-21-103-C03"],"award-info":[{"award-number":["S0316-21-103-C03"]}],"id":[{"id":"10.13039\/501100003665","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Trade, Industry and Energy (MOTIE), and Korea Institute for Advancement of Technology (KIAT)","award":["P0018445"],"award-info":[{"award-number":["P0018445"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Gait disturbance is a common sequela of stroke. Conventional gait analysis has limitations in simultaneously assessing multiple joints. Therefore, we investigated the gait characteristics in stroke patients using hip-knee cyclograms, which have the advantage of simultaneously visualizing the gait kinematics of multiple joints. Stroke patients (n = 47) were categorized into two groups according to stroke severity, and healthy controls (n = 32) were recruited. An inertial measurement unit sensor-based gait analysis system, which requires placing seven sensors on the dorsum of both feet, the shafts of both tibias, the middle of both femurs, and the lower abdomen, was used for the gait analysis. Then, the hip-knee cyclogram parameters (range of motion, perimeter, and area) were obtained from the collected data. The coefficient of variance of the cyclogram parameters was obtained to evaluate gait variability. The cyclogram parameters differed between the stroke patients and healthy controls, and differences according to stroke severity were also observed. The gait variability parameters mainly differed in patients with more severe stroke, and specific visualized gait patterns of stroke patients were obtained through cyclograms. In conclusion, the hip-knee cyclograms, which show inter-joint coordination and visualized gait cycle in stroke patients, are clinically significant.<\/jats:p>","DOI":"10.3390\/s21227685","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T02:43:31Z","timestamp":1637289811000},"page":"7685","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Analysis of Gait Characteristics Using Hip-Knee Cyclograms in Patients with Hemiplegic Stroke"],"prefix":"10.3390","volume":"21","author":[{"given":"Ho Seok","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hokyoung","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Technology Management, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Uk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-sung","family":"Cho","sequence":"additional","affiliation":[{"name":"Korea Orthopedics & Rehabilitation Engineering Center, 26, Gyeongin-ro 10beon-gil, Bupyeong-gu, Incheon 21417, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-9523","authenticated-orcid":false,"given":"Sungmin","family":"You","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5619-4818","authenticated-orcid":false,"given":"Jae Hyeon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri-si 11923, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0241-0954","authenticated-orcid":false,"given":"Seong-Ho","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea"},{"name":"Department of Rehabilitation Medicine, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri-si 11923, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","article-title":"Heart disease and stroke statistics\u20142021 update: A report from the American Heart Association","volume":"143","author":"Virani","year":"2021","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.pmrj.2013.12.017","article-title":"Gait disturbances in patients with stroke","volume":"6","author":"Balaban","year":"2014","journal-title":"PM&R"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.3389\/fphys.2018.01021","article-title":"Post-stroke Hemiplegic Gait: New Perspective and Insights","volume":"9","author":"Li","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.bspc.2018.01.013","article-title":"Gait symmetry measures: A review of current and prospective methods","volume":"42","author":"Viteckova","year":"2018","journal-title":"Biomed. Signal Process. Control."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Boudarham, J., Roche, N., Pradon, D., Bonnyaud, C., Bensmail, D., and Zory, R. (2013). Variations in kinematics during clinical gait analysis in stroke patients. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0066421"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1053\/apmr.2001.24907","article-title":"Responsiveness and predictability of gait speed and other disability measures in acute stroke","volume":"82","author":"Salbach","year":"2001","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1161\/STROKEAHA.106.475921","article-title":"Improvements in speed-based gait classifications are meaningful","volume":"38","author":"Schmid","year":"2007","journal-title":"Stroke"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1093\/ptj\/64.1.35","article-title":"Clinical gait assessment in the neurologically impaired: Reliability and meaningfulness","volume":"64","author":"Holden","year":"1984","journal-title":"Phys. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/S1052-3057(99)80006-8","article-title":"Quantitative kinematics of gait patterns during the recovery period after stroke","volume":"8","author":"Mah","year":"1999","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.apmr.2004.04.036","article-title":"Functional recovery of gait and joint kinematics after right hemispheric stroke","volume":"85","author":"Huitema","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1161\/01.STR.26.6.982","article-title":"Classification of walking handicap in the stroke population","volume":"26","author":"Perry","year":"1995","journal-title":"Stroke"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0966-6362(98)00014-9","article-title":"A new gait parameterization technique by means of cyclogram moments: Application to human slope walking","volume":"8","author":"Goswami","year":"1998","journal-title":"Gait Posture"},{"key":"ref_13","first-page":"109","article-title":"Angle--angle diagrams in the assessment of locomotion","volume":"59","author":"Hershler","year":"1980","journal-title":"Am. J. Phys. Med."},{"key":"ref_14","first-page":"1","article-title":"Effects of knee osteoarthritis severity on inter-joint coordination and gait variability as measured by hip-knee cyclograms","volume":"11","author":"Park","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121005","DOI":"10.1115\/1.4040774","article-title":"Cyclogram-based joint symmetry assessment after utilization of a foot drop stimulator during post-stroke hemiplegic gait","volume":"140","author":"Pilkar","year":"2018","journal-title":"J. Biomech. Eng."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.apmr.2007.06.764","article-title":"Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke","volume":"88","author":"Mehrholz","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"872","DOI":"10.5535\/arm.2018.42.6.872","article-title":"Evaluation of Validity and Reliability of Inertial Measurement Unit-Based Gait Analysis Systems","volume":"42","author":"Cho","year":"2018","journal-title":"Ann. Rehabil. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"415","DOI":"10.5535\/arm.20071","article-title":"Novel Method of Classification in Knee Osteoarthritis: Machine Learning Application Versus Logistic Regression Model","volume":"44","author":"Yang","year":"2020","journal-title":"Ann. Rehabil. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Qiu, S., Zhao, H., Jiang, N., Wu, D., Song, G., Zhao, H., and Wang, Z. (2021). Sensor network oriented human motion capture via wearable intelligent system. Int. J. Intell. Syst., Available online: https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1002\/int.22689.","DOI":"10.1002\/int.22689"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.inffus.2019.06.023","article-title":"Gait-based identification for elderly users in wearable healthcare systems","volume":"53","author":"Sun","year":"2020","journal-title":"Inf. Fusion"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.inffus.2021.09.016","article-title":"Multi-modal gait: A wearable, algorithm and data fusion approach for clinical and free-living assessment","volume":"78","author":"Celik","year":"2022","journal-title":"Inf. Fusion"},{"key":"ref_22","unstructured":"Madgwick, S.O. (2010). Automated Calibration of an Accelerometers, Magnetometers and Gyroscopes\u2014A Feasibility Study, Tehc Rep, x-io Technologies Limited. Available online: http:\/\/www.x-io.co.uk\/res\/doc\/automated_calibration_feasibility_study.pdf."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cloete, T., and Scheffer, C. (2008, January 20\u201325). Benchmarking of a full-body inertial motion capture system for clinical gait analysis. Proceedings of the 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Vancouver, BC, Canada.","DOI":"10.1109\/IEMBS.2008.4650232"},{"key":"ref_24","first-page":"161","article-title":"Development of gait distance measurement system based on inertial measurement units","volume":"9","author":"Lee","year":"2015","journal-title":"J. Rehabil. Welf. Eng. Assist. Technol."},{"key":"ref_25","first-page":"48","article-title":"A study of gait and posture with the use of cyclograms","volume":"50","year":"2010","journal-title":"Acta Polytech."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.gaitpost.2008.10.061","article-title":"Variability in spatiotemporal step characteristics and its relationship to walking performance post-stroke","volume":"29","author":"Balasubramanian","year":"2009","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1743-0003-2-19","article-title":"Gait variability: Methods, modeling and meaning","volume":"2","author":"Hausdorff","year":"2005","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/j.jelekin.2011.07.011","article-title":"Effect of severity of knee osteoarthritis on the variability of gait parameters","volume":"21","author":"Kiss","year":"2011","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_29","unstructured":"Zwillinger, D. (2018). CRC Standard Mathematical Tables and Formulas, Chapman and Hall\/CRC. [33th ed.]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/0966-6362(96)01063-6","article-title":"Hemiparetic gait following stroke. Part I: Characteristics","volume":"4","author":"Olney","year":"1996","journal-title":"Gait Posture"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jbiomech.2018.03.015","article-title":"Inter-joint coordination of kinematics and kinetics before and after total hip arthroplasty compared to asymptomatic subjects","volume":"72","author":"Longworth","year":"2018","journal-title":"J. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0966-6362(02)00165-0","article-title":"Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following stroke","volume":"18","author":"Mulroy","year":"2003","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/pri.528","article-title":"The relationship of lower limb muscle strength and knee joint hyperextension during the stance phase of gait in hemiparetic stroke patients","volume":"17","author":"Cooper","year":"2012","journal-title":"Physiother. Res. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.gaitpost.2021.08.016","article-title":"Treatment of knee hyperextension in post-stroke gait. A systematic review","volume":"91","author":"Geerars","year":"2021","journal-title":"Gait Posture"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.gaitpost.2017.03.021","article-title":"The high cost of swing leg circumduction during human walking","volume":"54","author":"Shorter","year":"2017","journal-title":"Gait Posture"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1310\/JB16-V04F-JAL5-H1UV","article-title":"Characteristics of gait in hemiplegia","volume":"7","author":"Woolley","year":"2001","journal-title":"Top. Stroke Rehabil."},{"key":"ref_37","first-page":"1","article-title":"Effectiveness of an ankle\u2013foot orthosis on walking in patients with stroke: A systematic review and meta-analysis","volume":"11","author":"Choo","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_38","first-page":"103","article-title":"The effects of a short ankle-foot orthosis on gait in patients with post-stroke hemiplegia","volume":"24","author":"Chang","year":"2019","journal-title":"Neurol. Asia"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/22\/7685\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:32:34Z","timestamp":1760167954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/22\/7685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,19]]},"references-count":38,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["s21227685"],"URL":"https:\/\/doi.org\/10.3390\/s21227685","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,19]]}}}