Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Gait Posture. 2011 Feb;33(2):238-43. doi: 10.1016/j.gaitpost.2010.11.012. Epub 2010 Dec 17.
The purpose of the present study was to describe the spatial-temporal parameters of the centre of pressure (COP) trajectory during the single-support phase of gait among stroke survivors and relate these parameters to the severity of sensorimotor impairment. Fifty-seven participants were asked to walk at their preferred and fast speed over a pressure sensitive mat. Outcome measures included anterior-posterior (AP) COP displacement, AP-COP velocity, medial-lateral (ML) COP variability and foot region COP time. The results demonstrated an asymmetrical AP-COP displacement in favour of the non-paretic limb for the majority of participants. The inter-limb difference scores for AP-COP displacement and AP-COP velocity were related to the severity of sensorimotor impairment and greater among gait aid users. ML-COP variability was greater under the non-paretic limb, possibly suggesting difficulty with paretic limb swing phase. Reduced or absent forefoot COP time suggests difficulty with forward progression and modified foot function during push-off. The inter-limb difference in COP parameters highlights the asymmetrical nature of post-stroke gait and the challenge of maintaining single limb support. We view this information as potentially important to clinicians as an outcome measure for gait rehabilitation.
本研究的目的是描述脑卒中患者在步态单支撑相期间的足中心点(COP)轨迹的时空参数,并将这些参数与感觉运动功能障碍的严重程度联系起来。 57 名参与者被要求在压力感应垫上以他们的惯用速度和快速速度行走。 评估指标包括前后向(AP)COP 位移、AP-COP 速度、内外侧(ML)COP 变异性和足区 COP 时间。 结果表明,大多数参与者的 AP-COP 位移偏向非瘫痪侧,表现出不对称性。 AP-COP 位移和 AP-COP 速度的肢体间差异评分与感觉运动功能障碍的严重程度有关,在使用助行器的患者中更大。 非瘫痪侧的 ML-COP 变异性更大,可能提示瘫痪侧摆动相困难。 前足 COP 时间减少或缺失提示在推进阶段和蹬离时足功能发生改变,存在困难。 COP 参数的肢体间差异突出了脑卒中后步态的不对称性和单肢支撑维持的挑战。 我们认为这些信息对临床医生来说可能很重要,是步态康复的一种评估指标。