Classification of Hemiplegic Gait and Mimicked Hemiplegic Gait: A Treadmill Gait Analysis Study in Stroke Patients and Healthy Individuals

Differentiating genuine hemiplegic gait (HG) in stroke survivors from hemiplegic-like gait voluntarily imitated by healthy adults (MHG) is essential for reliable assessment and intervention planning. Treadmill-based gait data were obtained from 79 participants-39 stroke patients (HG) and 40 healthy adults-instructed to mimic HG (MHG). Forty-eight spatiotemporal and force-related variables were extracted. Random Forest, support vector machine (SVM), and logistic regression classifiers were trained with (i) the full feature set and (ii) the 10 most important features selected via Random Forest Gini importance. Performance was assessed with 5-fold stratified cross-validation and an 80/20 hold-out test, using accuracy, F1-score, and the area under the receiver operating characteristic curve (AUC). All models achieved high discrimination (AUC > 0.93). The SVM attained perfect discrimination (AUC = 1.000, test set) with the full feature set and maintained excellent accuracy (AUC = 0.983) with only the top 10 features. Temporal asymmetries, delayed vertical ground reaction force peaks, and mediolateral spatial instability ranked highest in importance. Reduced-feature models showed negligible performance loss, highlighting their parsimony and interpretability. Supervised machine learning algorithms can accurately distinguish true hemiplegic gait from mimicked patterns using a compact subset of gait features. The findings support data-driven, time-efficient gait assessments for clinical neurorehabilitation and for validating experimental protocols that rely on gait imitation.