Université de Savoie, Domaine Universitaire du Bourget-du-Lac, Bourget-du-Lac, France.
Neurorehabil Neural Repair. 2012 Feb;26(2):173-7. doi: 10.1177/1545968311412786. Epub 2011 Jul 6.
For individuals with lateral postural imbalance after stroke, the decision to adopt a cane for walking often is not based on objective findings.
The authors investigated the explanatory value of 2 posturographic criteria for lateral postural imbalance on the walking abilities of poststroke subjects.
Indices of postural asymmetry (percentage of body weight on the less loaded lower limb) and instability (mediolateral variance of center-of-pressure displacements) were measured in 40 healthy individuals and 52 patients (mean 94.2 days after first hemispheric stroke), who stood still on a double force platform. Cut-off values (mean ± 2 standard deviations) were calculated and compared. The predictive value of both postural indices on walking abilities with or without a cane was analyzed.
Of the patients, 34.6% were unstable along the mediolateral axis (variance >7 mm(2)), and 44.2% were asymmetrical (body weight <40%); 30% needed a technical aid and 35% walked without a cane. The probability of being able to walk without a cane was less than 5% if the paretic lower limb was not loaded more than 40%. The postural instability index was less informative.
This study suggests that patients who do not load more than 40% of their body weight on their paretic lower limb may benefit from the prescription of a cane.
对于患有脑卒中后侧向姿势失衡的个体，采用拐杖行走的决定往往不是基于客观发现。
作者研究了 2 项姿势图标准对脑卒中后患者行走能力的侧向姿势失衡的解释价值。
在 40 名健康个体和 52 名患者（首次半球性卒中后平均 94.2 天）中测量了姿势不对称（承重较小下肢的体重百分比）和不稳定（压力中心位移的横侧向方差）的指数。计算并比较了截断值（平均值±2 个标准差）。分析了两种姿势指数对有或无拐杖行走能力的预测价值。
在患者中，34.6%的患者在横侧向轴上不稳定（方差>7mm2），44.2%的患者不对称（体重<40%）；30%需要技术辅助，35%无拐杖行走。如果患侧下肢承重不到 40%，则无需拐杖行走的可能性小于 5%。姿势不稳定指数的信息量较小。
本研究表明，承重不到其患侧下肢体重 40%的患者可能受益于拐杖的处方。
