Chow John W, Yablon Stuart A, Horn Terry S, Stokic Dobrivoje S
Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, MS 39216, USA.
Brain Inj. 2010;24(13-14):1575-84. doi: 10.3109/02699052.2010.523053. Epub 2010 Oct 25.
To characterize gait characteristics of adults with traumatic brain injury (TBI) and lower limb muscle hypertonia, distinguishing gait adaptations inherent to TBI motor impairment from those of healthy subjects walking at slower speed.
Temporospatial and kinematic data of 31 patients with TBI (41 ± 30 months post-injury) walking at self-selected speed (free speed) were compared with 31 healthy subjects walking at free and very slow speeds using an optoelectronic motion analysis system.
All step parameters differed (p < 0.05) between more affected (MA) and less affected (LA) sides in TBI except foot angle and toe clearance. Significant differences existed between TBI and controls in most parameters regardless of speed. These differences frequently involved the LA side. In TBI, most temporospatial parameters significantly correlated with stride velocity, whereas the averaged lower limb Ashworth score on the MA side (2.1 ± 0.4) showed few significant correlations.
Gait deviations in subjects with TBI and lower limb muscle hypertonia cannot be solely explained by slower walking. The preponderance of changes involving the LA side particularly suggests prevalent use of compensatory walking strategies. Temporospatial gait parameters are not closely related to static measures of muscle hypertonia after TBI.
描述创伤性脑损伤（TBI）合并下肢肌肉张力亢进的成年人的步态特征，区分TBI运动障碍所固有的步态适应与以较慢速度行走的健康受试者的步态适应。
使用光电运动分析系统，将31例TBI患者（受伤后41±30个月）以自选速度（自由速度）行走时的时空和运动学数据，与31名以自由速度和非常慢的速度行走的健康受试者进行比较。
TBI患者中，除足角和足趾离地间隙外，患侧（MA）和未患侧（LA）之间的所有步参数均存在差异（p<0.05）。无论速度如何，TBI患者与对照组在大多数参数上均存在显著差异。这些差异常涉及LA侧。在TBI患者中，大多数时空参数与步幅速度显著相关，而MA侧下肢Ashworth评分平均值（2.1±0.4）显示出的显著相关性较少。
TBI合并下肢肌肉张力亢进患者的步态偏差不能仅用行走速度较慢来解释。涉及LA侧的变化占优势尤其表明普遍使用了代偿性行走策略。TBI后时空步态参数与肌肉张力亢进的静态测量指标没有密切关系。
