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中风患者亚组中的时空和运动不对称比率

Spatio-temporal and kinematic asymmetry ratio in subgroups of patients with stroke.

作者信息

Oken O, Yavuzer G

机构信息

Physical Medicine and Rehabilitation Clinic, Ankara State Hospital, Ankara, Turkey.

出版信息

Eur J Phys Rehabil Med. 2008 Jun;44(2):127-32.

Abstract

AIM

To determine the spatio-temporal and kinematic gait asymmetry in hemiparetic patients after stroke, and to compare the subgroups in terms of asymmetry ratio.

METHODS

Spatio-temporal and kinematic characteristics of gait in 100 patients (37 females, 63 males) with hemiparesis after stroke were retrospectively evaluated. The mean+/-SD age was 57.9+/-12.1 years (range 18-80) and time since stroke was 5.75+/-5.9 months (range 1-36). Subgroups were based on age, gender, side of paresis, lesion type, motor recovery level, sensory status, time since stroke and walking velocity.

RESULTS

The older patients (65 years) had a higher temporal asymmetry in terms of single-support time whereas the younger patients (<65 years) had a higher kinematic asymmetry in terms of ankle joint kinematics at both stance and swing phases (P<0.05). In the poor motor recovery group, asymmetry ratios of step length, hip and knee extension at stance, and ankle kinematics were significantly higher than those of the good motor recovery group (P<0.05). In the slow walking group, step length showed a greater asymmetry than in the fast walking group (P<0.05). Gait asymmetry was similar among the patients when they were grouped according to their gender, side of paresis, lesion type, proprioception, and time since stroke.

CONCLUSION

For better interpretation of quantitative gait data and to offer appropriate rehabilitation programs, clinicians should consider that spatio-temporal and kinematic asymmetry might vary according to age, motor recovery level and walking speed of hemiparetic patients after stroke.

摘要

目的

确定脑卒中后偏瘫患者的时空和运动步态不对称性,并比较各亚组的不对称率。

方法

回顾性评估100例脑卒中后偏瘫患者(37例女性,63例男性)的步态时空和运动特征。平均年龄±标准差为57.9±12.1岁(范围18 - 80岁),脑卒中后时间为5.75±5.9个月(范围1 - 36个月)。亚组基于年龄、性别、偏瘫侧、病变类型、运动恢复水平、感觉状态、脑卒中后时间和步行速度划分。

结果

老年患者(≥65岁)在单支撑时间方面存在较高的时间不对称性,而年轻患者(<65岁)在站立期和摆动期踝关节运动学方面存在较高的运动不对称性(P<0.05)。在运动恢复较差的组中,步长、站立期髋关节和膝关节伸展以及踝关节运动学的不对称率显著高于运动恢复良好的组(P<0.05)。在慢步行组中,步长的不对称性比快步行组更大(P<0.05)。根据性别、偏瘫侧、病变类型、本体感觉和脑卒中后时间对患者进行分组时,步态不对称性相似。

结论

为了更好地解释定量步态数据并提供合适的康复方案,临床医生应考虑到脑卒中后偏瘫患者的时空和运动不对称性可能会因年龄、运动恢复水平和步行速度而有所不同。

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