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在脑卒中后患者进行水上跑步机行走时,给患腿施加额外重量对步态模式的影响。

The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke.

机构信息

Center of Achievement, Department of Kinesiology, California State University, Northridge, Northridge, CA, USA.

出版信息

Arch Phys Med Rehabil. 2010 Jan;91(1):129-36. doi: 10.1016/j.apmr.2009.09.012.

Abstract

UNLABELLED

Jung T, Lee D, Charalambous C, Vrongistinos K. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke.

OBJECTIVE

To investigate how the application of additional weights to the affected leg influences gait patterns of people poststroke during aquatic treadmill walking.

DESIGN

Comparative gait analysis.

SETTING

University-based aquatic therapy center.

PARTICIPANTS

Community-dwelling volunteers (n=22) with chronic hemiparesis caused by stroke.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Spatiotemporal and kinematic gait parameters.

RESULTS

The use of an ankle weight showed an increase in the stance phase percentage of gait cycle (3%, P=.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion (7.9%, P=.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people poststroke typically show excessive hip flexion of the paretic leg in the late swing phase followed by fluctuating hip movements during aquatic treadmill walking. The frontal and transverse plane hip motions did not show any significant differences but displayed a trend of a decrease in the peak hip abduction during the swing phase with additional weights. The use of additional weight did not alter sagittal plane kinematics of the knee and ankle joints.

CONCLUSIONS

The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side during aquatic treadmill walking. It can also assist the stance stability by increasing the stance phase percentage closer to 60% of gait cycle. Both findings can contribute to the development of more efficient motor patterns in gait training for people poststroke. The use of a cuff weight does not seem to reduce the limb circumduction during aquatic treadmill walking.

摘要

未加标签

Jung T、Lee D、Charalambous C、Vrongistinos K。在水中跑步机上行走时,给患腿施加额外重量对脑卒中后患者步态模式的影响。

目的

研究给患腿施加额外重量如何影响脑卒中后患者在水中跑步机上行走时的步态模式。

设计

比较步态分析。

设置

大学水上治疗中心。

参与者

有慢性偏瘫的社区志愿者(n=22),由中风引起。

干预措施

不适用。

主要观察指标

时空和运动学步态参数。

结果

与不使用重量相比,使用脚踝重量使步态周期的站立相百分比增加(3%,P=.015)。然而,经过更严格的统计分析的 Bonferroni 调整后,差异并不显著。步频和步长没有显著差异。与不使用重量的情况相比,使用脚踝重量会导致患侧髋关节屈曲的峰值明显降低(7.9%,P=.001)。这种减少被标记为由于脑卒中后患者在水中跑步机上行走时通常会出现过度的患侧髋关节屈曲,随后髋关节运动不稳定,从而减少了不必要的肢体漂浮。在额状面和横平面上,髋关节运动没有显示出任何显著差异,但在摆动相时显示出髋关节外展峰值减少的趋势,附加重量。附加重量不会改变膝关节和踝关节矢状面运动学。

结论

在水中跑步机上行走时,在患侧肢体上施加重量可以减少不必要的肢体漂浮。它还可以通过增加接近 60%的步态周期的站立相百分比来提高站立稳定性。这两种发现都有助于在脑卒中后患者的步态训练中发展更有效的运动模式。使用袖口重量似乎不会减少水中跑步机行走时的肢体环转运动。

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