地面上使用体重支撑：一种用于脑卒中患者步态训练的替代策略。
The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke.
机构信息
Graduate Program in Human Movement Sciences, Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, Rua Galvão Bueno, 868 13 degrees andar, Bloco B, 01506-000 São Paulo, Brazil.
出版信息
J Neuroeng Rehabil. 2009 Dec 1;6:43. doi: 10.1186/1743-0003-6-43.
BACKGROUND
Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training.
METHODS
Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments.
RESULTS
The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions.
CONCLUSION
Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.
背景
跑步机上的体重支撑（BWS）系统已被提议作为中风患者步态训练的一种策略。考虑到地面是最常见的运动表面，而且关于中风患者在地面上使用 BWS 行走的信息很少，因此了解这些个体在地面上使用 BWS 作为步态训练的一种可能替代策略非常重要。
方法
13 名慢性中风患者（4 名女性和 9 名男性；平均年龄 54.46 岁）在三种实验条件下进行地面行走录像：无吊带、全身体重吊带和 30%全身体重吊带。测量了平均行走速度、步频、步长、步速、初始和终末双支撑期、单肢支撑期、摆动期以及踝关节、膝关节和髋关节的活动范围；以及足部、小腿、大腿和躯干节段。
结果
BWS 系统的使用导致步长和速度发生变化，但支撑期和摆动期持续时间不变。只有在 30% BWS 条件下，BWS 系统才会影响髋关节。与其他条件相比，30% BWS 条件下的小腿和大腿节段活动范围较小，30% BWS 条件下的躯干保持更直。
结论
使用 BWS 系统的中风患者在地面上行走比无吊带时更慢，步长更短。BWS 还导致髋关节、小腿和大腿活动范围减小。然而，该系统并未改变中风患者的行走时间组织和身体侧不对称性。另一方面，BWS 系统使慢性中风患者能够安全行走而无需身体协助。在干预措施中，物理治疗师可以在患者表现中观察和纠正步态模式，而无需提供身体协助。
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