慢性卒中患者站立任务中负重能力的可靠性及比较
Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke.
作者信息
Eng Janice J, Chu Kelly S
机构信息
School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
出版信息
Arch Phys Med Rehabil. 2002 Aug;83(8):1138-44. doi: 10.1053/apmr.2002.33644.
OBJECTIVES
To determine the test-retest reliability over 2 separate days for weight-bearing ability during standing tasks in individuals with chronic stroke and to compare the weight-bearing ability among 5 standing tasks for the paretic and nonparetic limbs.
DESIGN
Prospective study using a convenient sample.
SETTING
Free-standing tertiary rehabilitation center.
PARTICIPANTS
Fifteen community-dwelling stroke individuals with moderate motor deficits; volunteer sample.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Weight-bearing ability as measured by the vertical ground reaction force during 5 standing tasks (rising from a chair, quiet standing, weight-shifting forward, backward, laterally).
RESULTS
The weight-bearing ability was less for the paretic limb compared with the nonparetic limb, but the intraclass correlation coefficients were high (.95-.99) for both limbs between the 2 sessions for all 5 tasks. The forward weight-shifting ability was particularly low in magnitude on the paretic side compared with the other weight-shifting tasks. In addition, the forward weight-shift ability of the nonparetic limb was also impaired but to a lesser extent. Large asymmetry was evident when rising from a chair, with the paretic limb bearing a mean 296N and the nonparetic side bearing a mean 458N. The weight-bearing ability during all 5 tasks correlated with one another (r range,.56-.94).
CONCLUSIONS
Weight-bearing ability can be reliably measured and may serve as a useful outcome measure in individuals with stroke. We suggest that impairments of the hemiparetic side during forward weight shifting and sit-to-stand tasks presents a challenge to the motor systems of individuals with stroke, which may account for the poor balance that is often observed in these individuals.
目的
确定慢性卒中患者在站立任务中负重能力在两个不同日期的重测信度,并比较患侧和健侧肢体在五项站立任务中的负重能力。
设计
采用方便抽样的前瞻性研究。
地点
独立的三级康复中心。
参与者
15名有中度运动障碍的社区居住卒中患者;志愿者样本。
干预措施
不适用。
主要观察指标
通过五项站立任务(从椅子上起身、安静站立、向前、向后、向侧方转移体重)期间的垂直地面反作用力测量负重能力。
结果
患侧肢体的负重能力低于健侧肢体,但所有五项任务的两次测试中,两侧肢体的组内相关系数均较高(0.95 - 0.99)。与其他体重转移任务相比,患侧向前转移体重的能力尤其低。此外,健侧肢体的向前体重转移能力也受损,但程度较轻。从椅子上起身时,明显存在较大不对称性,患侧肢体平均承重296N,健侧平均承重458N。所有五项任务中的负重能力彼此相关(r范围为0.56 - 0.94)。
结论
负重能力可以可靠地测量,并且可能作为卒中患者有用的结局指标。我们认为,向前体重转移和从坐到站任务中患侧偏瘫的损伤对卒中患者的运动系统构成挑战,这可能解释了这些患者中经常观察到的平衡能力差的原因。