Polese Janaine Cunha, Teixeira-Salmela Luci Fuscaldi, Nascimento Lucas Rodrigues, Faria Christina Danielli Morais, Kirkwood Renata Noce, Laurentino Glória Carneiro, Ada Louise
Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Clin Biomech (Bristol). 2012 Feb;27(2):131-7. doi: 10.1016/j.clinbiomech.2011.08.003. Epub 2011 Sep 1.
There are robust clinical paradigms against the prescription of walking sticks for people with stroke. However, there is little information on the biomechanics of gait with and without these devices to guide clinical practice. Therefore, this study investigated how the use of walking sticks (canes or crutches) affected both the kinematics and kinetics of gait in people with chronic stroke after their walking had stabilized.
Nineteen people with chronic stroke walked at both comfortable and fast speeds. A 3-D motion analysis system and one force platform were used to obtain kinematic and kinetic data of the paretic lower limb during four conditions: With and without walking sticks, and at comfortable and fast speeds. Outcomes included linear kinematics (walking speeds) and angular kinematics (maximum joint angles), power, and work of the paretic hip, knee and ankle joints in the saggital plane.
The use of walking sticks resulted in increases in speed during both fast (P<0.001) and comfortable (P=0.001) walking, but did not result in changes in maximum joint angles. This also led to increases in ankle plantar flexion (P<0.01), knee extension (P<0.01), and hip flexion (P<0.001) power generation, but did not result in changes in work. There were no greater changes as a result of using walking sticks during fast versus comfortable walking for any outcome. INTERPRETATIN: The outcomes with the use of walking sticks were beneficial, which suggests that the prescription of these devices is not detrimental to walking that was stabilized in people with stroke.
对于中风患者使用手杖开具处方，存在强有力的临床范例。然而，关于使用和不使用这些器械时步态生物力学的信息很少，难以指导临床实践。因此，本研究调查了在慢性中风患者步行稳定后，使用手杖（拐杖或腋杖）如何影响其步态的运动学和动力学。
19名慢性中风患者以舒适速度和快速速度行走。使用三维运动分析系统和一个测力平台，在四种情况下获取患侧下肢的运动学和动力学数据：使用和不使用手杖，以及在舒适速度和快速速度下。结果包括线性运动学（步行速度）和角运动学（最大关节角度）、功率，以及矢状面内患侧髋、膝和踝关节的功。
使用手杖在快速行走（P<0.001）和舒适行走（P=0.001）时均能提高速度，但未导致最大关节角度发生变化。这也导致踝关节跖屈功率（P<0.01）、膝关节伸展功率（P<0.01）和髋关节屈曲功率（P<0.001）增加，但未导致功发生变化。对于任何结果，在快速行走和舒适行走时使用手杖均未产生更大的变化。
使用手杖的结果是有益的，这表明开具这些器械的处方对中风患者已稳定的步行并无不利影响。
