Alterations in Supine Position Mobility and Dynamics in Post-Stroke Individuals with Hemiparesis Compared to Neurologically Intact Controls: A Video-Based Observational Assessement.

Background/Objectives: The aim of this study was a video-based observational assessment of movement strategies during supine position transfers in patients with hemiparesis following a first-ever ischemic stroke. Methods: The study included 51 participants (n = 51), covering 20 healthy individuals (n = 20) and 31 patients (n = 31) after their first ischemic stroke with hemiparesis. All participants underwent observational kinematic analysis of supine mobility using video recording and time-lapse analysis. The assessment focused on the time required to complete the task, the number of pelvic movements, the presence of trunk translation, spinal flexion, and pelvic mobility across three planes. Results: In the control group, transfers followed a consistent and repetitive sequence in both directions, typically involving trunk translation, spinal flexion, pelvic elevation, and symmetrical movement of both upper and lower limbs. In contrast, post-stroke patients demonstrated altered, asymmetrical, and less efficient movement patterns. These movement strategies were consistent across the hemiparetic group and characterized typical motor responses following stroke. The average transfer time in the study group was approximately three times longer than in the control group. The average number of pelvic movements was 7.2 ± 2.44 in healthy individuals and 16.71 ± 13.52 in post-stroke patients. Conclusions: Supine transfers should be routinely assessed in patients after stroke and included as a key focus in physiotherapy goals. The movement patterns required for such transfers represent a distinct component of complex motor function. Both qualitative and quantitative aspects of their execution may have a significant impact on functional independence in individuals with hemiparesis. Identifying typical transfer patterns in hemiparetic patients may offer valuable guidance for early post-stroke rehabilitation planning, particularly in preventing maladaptive compensatory strategies.