Longitudinal characterization of gait and balance recovery over 1 year using instrumented analysis in a school-aged child with ischemic stroke: a case report

BACKGROUND: Young-onset ischemic stroke may lead to persistent motor impairment, despite favorable survival outcomes. However, a detailed longitudinal characterization of gait and balance recovery in young patients remains limited. Instrumented assessments using inertial measurement units and force platforms may provide objective insights into the temporal patterns of functional recovery. CASE PRESENTATION: We report the case of a previously healthy 11-year-old Japanese girl who developed left hemiparesis due to an ischemic stroke associated with reversible cerebral vasoconstriction syndrome. Gait and balance were assessed longitudinally at 1, 2, 6, 9, and 12 months after onset, using instrumented analysis. Gait stability was quantified using the root mean square (RMS) of trunk acceleration, symmetry using the Lissajous index (LI), and rhythmicity using stride-to-stride time variability (STV). Balance was evaluated using the index of postural stability (IPS). The RMS and IPS improved markedly within the first 6 months, followed by more gradual changes. Gait symmetry continued to improve for up to 9 months. The STV showed a transient increase during early recovery and decreased after 12 months. Lower limb motor function improved from Brunnstrom stage II to stage V during the subacute phase, with corresponding gains in the Fugl-Meyer lower extremity scores. CONCLUSIONS: This case suggests that the recovery of gait stability, symmetry, and rhythmicity after childhood ischemic stroke may follow partially distinct temporal patterns during the first year. Longitudinal instrumented assessments may support stage-specific rehabilitation planning. Further studies are warranted to determine whether similar recovery patterns are consistently observed in larger cohorts.