Department of Physical Therapy, University of Delaware, United States.
Gait Posture. 2011 Feb;33(2):314-7. doi: 10.1016/j.gaitpost.2010.11.024. Epub 2010 Dec 22.
Post-stroke gait impairments are common and result in slowed walking speeds and decreased community participation post-stroke. Treadmill training has recently emerged as an effective gait rehabilitation intervention. Furthermore, kinematic and kinetic data collected during treadmill walking are commonly used for assessing gait performance. The minimal detectable change (MDC) for gait variables provides a useful index to determine whether the magnitude of change in gait produced after an intervention is greater than the amount of change attributable to day-to-day variability in gait or test-retest measurement errors. The MDC values for kinematic, ground reaction force (GRF), spatial, and temporal variables collected during treadmill walking post-stroke have not been previously reported. The objective of this study was, therefore, to compute MDCs for post-stroke gait kinematics, GRF indices, temporal, and spatial measures during treadmill walking. Nineteen individuals with chronic post-stroke hemiparesis (12 males; age=47-75 years; 72.6±63.4 months since stroke) participated in 2 testing sessions separated by 20.7±26.8 days. Our results showed that test-retest reliability was excellent for all gait variables tested (intraclass correlation coefficients=0.799-0.986). MDCs were reported for hip, knee, and ankle joint angles (range 3.8° for trailing limb angles to 11.5° for hip extension), peak anterior GRF (2.85% body weight), mean vertical GRF (4.65% body weight), all temporal variables (range 3.2-4.2% gait cycle), and paretic step length (6.7 cm). These MDCs provide a useful reference to help interpret the magnitudes of changes in post-stroke gait variables.
脑卒中后步态障碍很常见,会导致步行速度减慢,脑卒中后参与社区活动的能力下降。跑步机训练最近已成为一种有效的步态康复干预措施。此外,在跑步机上行走时收集的运动学和动力学数据通常用于评估步态表现。步态变量的最小可检测变化(MDC)提供了一个有用的指标,可以确定干预后步态产生的变化幅度是否大于步态日常变化或测试-重测测量误差所致的变化幅度。以前没有报道过脑卒中后在跑步机上行走时的运动学、地面反力(GRF)、空间和时间变量的 MDC 值。因此,本研究的目的是计算脑卒中后跑步机行走时步态运动学、GRF 指标、时间和空间测量的 MDC 值。19 名慢性脑卒中偏瘫患者(男性 12 名;年龄 47-75 岁;脑卒中后 72.6±63.4 个月)参加了 2 次测试,间隔 20.7±26.8 天。我们的结果表明,所有测试的步态变量的测试-重测可靠性均很高(组内相关系数=0.799-0.986)。报告了髋关节、膝关节和踝关节角度(从后肢角度的 3.8°到髋关节伸展的 11.5°)、前向 GRF 峰值(2.85%体重)、平均垂直 GRF(4.65%体重)、所有时间变量(3.2-4.2%步态周期)和患侧步长(6.7cm)的 MDC 值。这些 MDC 值为解释脑卒中后步态变量的变化幅度提供了有用的参考。