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中风患者亚组定量步态数据的重复性和变异性

Repeatability and variation of quantitative gait data in subgroups of patients with stroke.

作者信息

Oken Oznur, Yavuzer Gunes, Ergöçen Salih, Yorgancioglu Z Rezan, Stam Henk J

机构信息

Physical Medicine & Rehabilitation Clinic of Ankara State Hospital, Ankara, Turkey.

出版信息

Gait Posture. 2008 Apr;27(3):506-11. doi: 10.1016/j.gaitpost.2007.06.007. Epub 2007 Aug 8.

Abstract

We aimed to determine the repeatability and variation of quantitative gait data in patients with stroke and to compare the subgroups in terms of gait variability. Time-distance and kinematic characteristics of gait were evaluated in 90 inpatients (30 women) with hemiparesis (mean+/-S.D. age 57.7+/-12.5 years and time since stroke 5.99+/-6.46 months). Subgroups were based on "gender", "side of paresis", "lesion type", "motor recovery level", "sensory status", "time since stroke" and "walking velocity". Repeatability was adequate to excellent in all stroke subgroups (ICC range 0.48-0.98). Walking velocity was the most repeatable gait parameter after stroke. Variation in step length was significantly higher in women than in men (CV 16% versus 9%, p<0.05). Slow walkers (walking velocity <0.34 m/s) had a higher variation than fast walkers in step length (CV 12.5% versus 7.5%, p<0.01), single support time (CV 11.9% versus 6.3%, p<0.05), peak hip extensions in stance (CV 11.5% versus 3.7%, p<0.01) and knee flexion in swing (CV 11.8% versus 6.5%, p<0.05). In our stroke patients, their age, time since injury, lesion characteristics, impaired proprioception or level of motor recovery had no effect on gait variability. For better interpretation of quantitative gait data, clinicians should consider that variation in step length, single support time, peak hip extension in stance and knee flexion in swing differs according to walking velocity after stroke.

摘要

我们旨在确定中风患者定量步态数据的可重复性和变异性,并比较不同亚组之间的步态变异性。对90例偏瘫住院患者(30例女性)的步态时间-距离和运动学特征进行了评估(平均年龄±标准差为57.7±12.5岁,中风后时间为5.99±6.46个月)。亚组基于“性别”、“偏瘫侧”、“病变类型”、“运动恢复水平”、“感觉状态”、“中风后时间”和“步行速度”进行划分。所有中风亚组的可重复性均为良好至优秀(组内相关系数范围为0.48 - 0.98)。中风后步行速度是最具可重复性的步态参数。女性的步长变异性显著高于男性(变异系数分别为16%和9%,p<0.05)。慢步行者(步行速度<0.34 m/s)在步长(变异系数分别为12.5%和7.5%,p<0.01)、单支撑时间(变异系数分别为11.9%和6.3%,p<0.05)、站立时髋部伸展峰值(变异系数分别为11.5%和3.7%,p<0.01)以及摆动期膝关节屈曲(变异系数分别为11.8%和6.5%,p<0.05)方面的变异性高于快步行者。在我们的中风患者中,他们的年龄、受伤后时间、病变特征、本体感觉受损或运动恢复水平对步态变异性没有影响。为了更好地解读定量步态数据,临床医生应考虑到中风后步长、单支撑时间、站立时髋部伸展峰值和摆动期膝关节屈曲的变异性会因步行速度而异。

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