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在有和无跌倒史的脑卒中患者进行计时起立行走测试时 180 度转身的运动学。

Kinematics of turning 180 degrees during the timed up and go in stroke survivors with and without falls history.

机构信息

University of Birmingham, Edgbaston, United Kingdom.

出版信息

Neurorehabil Neural Repair. 2010 May;24(4):358-67. doi: 10.1177/1545968309348508. Epub 2009 Oct 12.

Abstract

BACKGROUND

Community-dwelling, chronic stroke survivors are at risk of falling during turning and are more likely to sustain a hip fracture when they fall.

OBJECTIVE

This study quantifies kinematic differences between stroke survivors (mean +/- SD: 38.3 +/- 31.3 months post-stroke, 59.9 +/- 10.1 years of age), with (n = 9) and without a falls history (n = 9), and age-matched healthy counterparts (n = 18) in turning coordination during the 180 degrees turn around in the Timed "Up & Go" (TUG) test.

METHODS

Full-body kinematics were recorded while participants performed the 180 degrees turn around in the TUG. Dependent measures were time to turn, number of steps to turn, and measures of axial segment coordination. Result. Although participants who had a stroke and falls history took significantly longer to turn (mean +/- SD: 4.4 +/- 1.7 seconds) than age-matched controls (2.5 +/- 0.6 seconds), no kinematic differences were found in performance or in the axial segment coordination during turning that could contribute to falls history or falls risk.

CONCLUSIONS

These results indicate incidences of falls during turning following stroke may not be due to impaired movement patterns but due to the many other factors that are associated with falls, such as deficits in cognitive processes--attention or central integration--and/or sensory deficits.

摘要

背景

居住在社区中的慢性中风幸存者在转身时存在跌倒的风险,如果跌倒,更有可能导致髋部骨折。

目的

本研究量化了中风幸存者(平均 +/- SD:中风后 38.3 +/- 31.3 个月,59.9 +/- 10.1 岁)、有(n = 9)和无跌倒史(n = 9)以及年龄匹配的健康对照组(n = 18)在定时“站起来并走”(TUG)测试中的 180 度转身过程中的转身运动协调的运动学差异。

方法

参与者在 TUG 中进行 180 度转身时记录全身运动学。测量指标包括转身时间、转身步数和轴向节段协调度。结果:尽管有中风和跌倒史的参与者转身时间明显更长(平均 +/- SD:4.4 +/- 1.7 秒),但与年龄匹配的对照组(2.5 +/- 0.6 秒)相比,在转身过程中的表现或轴向节段协调度方面并没有发现与跌倒史或跌倒风险相关的运动学差异。

结论

这些结果表明,中风后转身时的跌倒发生率可能不是由于运动模式受损所致,而是由于与跌倒相关的许多其他因素所致,例如认知过程(注意力或中枢整合)和/或感觉缺陷的缺陷。

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