Duclos Cyril, Nadeau Sylvie, Lecours Julie
School of Rehabilitation, Université de Montréal, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal Rehabilitation Institute, Montreal, Canada.
Neurorehabil Neural Repair. 2008 Nov-Dec;22(6):715-22. doi: 10.1177/1545968308316000. Epub 2008 Sep 23.
In hemiparetic individuals, sit-to-stand (STS) transfer is characterized by asymmetric weight-bearing and altered trunk kinematics that can be improved by positioning the affected foot behind the nonaffected one.
To examine the influence of frontal trunk kinematics on medio-lateral displacements of the center of pressure (CP) during STS performed with the feet placed in 2 different positions, as well as relationships between these parameters, medio-lateral stability, and clinical scores of the participants.
Eighteen patients with chronic stroke and 15 control individuals were evaluated during sit-to-stand transfers either in spontaneous foot position or with their affected or dominant foot placed behind, respectively. Medio-lateral CP, pelvis, and shoulder displacement were analyzed using 3D kinematic and kinetic data recordings of the whole task. Motor and sensory impairment, spasticity, muscle strength, and equilibrium were evaluated by standard scales. The possible time during which a participant could prevent a fall (minimal time-to-contact) was used as a stability index.
Spontaneously, the deviation of the CP of stroke participants paralleled the tilt of the trunk toward the nonaffected side, as early as the first third of the task. With the affected foot placed behind, trunk position did not differ from those of control participants who executed the transfer spontaneously. Hemiparetic participants were less stable than control participants. Placement of the feet had no significant effect on the stability of either group. Stability was strongly associated with better motor scores on the Chedoke-McMaster Stroke Assessment.
In hemiparetic individuals, improving STS symmetry by positioning the affected foot behind the nonaffected one did not decrease medio-lateral stability, which was associated with the level of stroke-related motor impairments.
在偏瘫患者中，从坐到站（STS）转移的特点是负重不对称和躯干运动学改变，将患侧脚置于健侧脚后方可改善这些情况。
研究在双脚处于两种不同位置进行STS时，额状面躯干运动学对压力中心（CP）中外侧位移的影响，以及这些参数、中外侧稳定性和参与者临床评分之间的关系。
18名慢性中风患者和15名对照个体在进行从坐到站转移时分别接受评估，转移时脚的位置分别为自然位置、患侧脚置于健侧脚后方或优势脚置于健侧脚后方。使用整个任务的三维运动学和动力学数据记录分析中外侧CP、骨盆和肩部位移。通过标准量表评估运动和感觉障碍、痉挛、肌肉力量和平衡。将参与者能够预防跌倒的可能时间（最小接触时间）用作稳定性指标。
在任务的前三分之一时间，中风参与者的CP偏差就与躯干向健侧倾斜平行。当患侧脚置于健侧脚后方时，躯干位置与自然进行转移的对照参与者没有差异。偏瘫参与者比对照参与者稳定性差。脚的位置对两组的稳定性均无显著影响。稳定性与Chedoke-McMaster中风评估中更好的运动评分密切相关。
在偏瘫个体中，将患侧脚置于健侧脚后方以改善STS对称性并不会降低中外侧稳定性，而中外侧稳定性与中风相关运动障碍的程度有关。
