Lamontagne Anouk, Paquette Caroline, Fung Joyce
School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
Neurorehabil Neural Repair. 2007 Jan-Feb;21(1):62-7. doi: 10.1177/1545968306290822.
In healthy subjects, the act of walking and turning is accomplished by a sequential horizontal reorientation of gaze, head, and body toward the direction of the turn. Subjects with stroke, however, have difficulty altering their walking direction and present with loss of balance when performing a head turn or whole body rotation.
To study, in a pilot case study, the spatial and temporal coordination of gaze and posture during preplanned turns executed while walking in severely disabled and mildly disabled subjects with stroke as compared to a healthy control walking at slow speed.
Horizontal plane orientations of gaze, head, thorax, pelvis, and feet as well as the body's center of mass (CoM) trajectory were analyzed as subjects were walking straight or executing a 90-deg turn.
Subjects with stroke revealed altered orientation and sequencing of gaze body segments. These alterations were more pronounced in the most severely disabled subject with stroke, especially when turning to the nonparetic side as compared to the paretic side.
These findings suggest an altered coordination of gaze and posture during steering of locomotion in subjects with stroke. This altered coordination is likely due to a complex interaction of motor, sensory, and biomechanical factors that may explain the poor balance and poor control of heading direction during walking and turning in stroke.
在健康受试者中，行走和转身动作是通过将目光、头部和身体依次水平重新定向至转身方向来完成的。然而，中风患者在改变行走方向时存在困难，并且在进行头部转动或全身旋转时会出现平衡丧失。
在一项先导性病例研究中，研究与以慢速行走的健康对照相比，重度残疾和轻度残疾的中风患者在行走过程中执行预先计划的转身时，目光与姿势的空间和时间协调性。
当受试者直行或执行90度转弯时，分析其目光、头部、胸部、骨盆和足部在水平面上的方向以及身体重心（CoM）轨迹。
中风患者表现出目光与身体各节段的方向和顺序改变。这些改变在重度残疾的中风患者中更为明显，尤其是与向患侧转身相比，向非患侧转身时。
这些发现表明中风患者在运动转向过程中目光与姿势的协调性发生了改变。这种协调性改变可能是由于运动、感觉和生物力学因素的复杂相互作用所致，这可能解释了中风患者在行走和转身过程中平衡能力差和头部方向控制不佳的原因。
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