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脑卒中后步行时的髋关节外展控制——手杖、贴扎和 TheraTogs 对步态的即时影响。

Hip abductor control in walking following stroke -- the immediate effect of canes, taping and TheraTogs on gait.

机构信息

Bildungszentrum Gesundheit Basel Stadt, Studiengang Physiotherapie FH, Munchenstein, Switzerland.

出版信息

Clin Rehabil. 2010 Jan;24(1):37-45. doi: 10.1177/0269215509342335. Epub 2009 Nov 11.

Abstract

OBJECTIVE

To confirm previous findings that hip abductor activity measured by electromyography (EMG) on the side contralateral to cane use is reduced during walking in stroke patients. To assess whether an orthosis (TheraTogs) or hip abductor taping increase hemiplegic hip abductor activity compared with activity during cane walking or while walking without aids. To investigate the effect of each condition on temporo-spatial gait parameters.

DESIGN

Randomized, within-participant experimental study.

SETTING

Gait laboratory.

SUBJECTS

Thirteen patients following first unilateral stroke.

INTERVENTION

Data collection over six gait cycles as subjects walked at self-selected speed during: baseline (without aids) and in randomized order with (1) hip abductor taping, (2) TheraTogs, (3) cane in non-hemiplegic hand.

MAIN MEASURES

Peak EMG of gluteus medius and tensor fascia lata and temporo-spatial gait parameters.

RESULTS

Cane use reduced EMG activity in gluteus medius from baseline by 21.86%. TheraTogs increased it by 16.47% (change cane use-TheraTogs P = 0.001, effect size = -0.5) and tape by 5.8% (change cane use-tape P = 0.001, effect size = -0.46). In tensor fascia lata cane use reduced EMG activity from baseline by 19.14%. TheraTogs also reduced EMG activity from baseline by 1.10% (change cane use-TheraTogs P = 0.009, effect size -0.37) and tape by 3% (not significant). Gait speed (m/s) at: baseline 0.44, cane use 0.45, tape 0.48, TheraTogs 0.49.

CONCLUSION

Hip abductor taping and TheraTogs increase hemiplegic hip abductor activity and gait speed during walking compared with baseline and cane use.

摘要

目的

证实先前的发现,即在使用拐杖的对侧,通过肌电图(EMG)测量的髋关节外展肌活动在中风患者行走时减少。评估矫形器(TheraTogs)或髋关节外展肌贴带是否比在使用拐杖或在没有辅助工具的情况下行走时增加偏瘫髋关节外展肌的活动。研究每种情况对时间-空间步态参数的影响。

设计

参与者内随机实验研究。

设置

步态实验室。

参与者

13 名首次单侧中风后患者。

干预

在患者以自我选择的速度行走时,在六个步态周期内收集数据:基线(无辅助工具),并以随机顺序进行:(1)髋关节外展肌贴带,(2)TheraTogs,(3)非偏瘫手使用拐杖。

主要测量指标

臀中肌和阔筋膜张肌的肌电图峰值和时间-空间步态参数。

结果

与基线相比,拐杖使用将臀中肌的肌电图活动减少了 21.86%。TheraTogs 将其增加了 16.47%(使用拐杖-TheraTogs 的变化 P = 0.001,效应大小=-0.5),而胶带增加了 5.8%(使用拐杖-胶带的变化 P = 0.001,效应大小=-0.46)。在阔筋膜张肌中,拐杖使用将肌电图活动从基线减少了 19.14%。TheraTogs 也将肌电图活动从基线减少了 1.10%(使用拐杖-TheraTogs 的变化 P = 0.009,效应大小-0.37),胶带减少了 3%(无显著差异)。在步态速度(m/s)方面:基线为 0.44,拐杖使用为 0.45,胶带为 0.48,TheraTogs 为 0.49。

结论

与基线和拐杖使用相比,髋关节外展肌贴带和 TheraTogs 增加了偏瘫髋关节外展肌的活动和行走速度。

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