Department of Physiotherapy, Royal Talbot Rehabilitation Centre Austin Health, Melbourne, Australia.
Disabil Rehabil. 2013 Jul;35(15):1302-7. doi: 10.3109/09638288.2012.729646. Epub 2012 Dec 5.
To investigate the basic spatio-temporal gait characteristics of people with stroke whilst walking on sloped and level terrain, and to compare this performance to healthy matched adults.
Fifteen community dwelling people with stroke who walked with a hemiplegic gait and a reference group of 15 adults without impairments matched for sex, age and height participated in this descriptive, observational study. Basic gait spatio-temporal measures were recorded at self-selected speed across a GAITRite mat placed on level, uphill and downhill (ramp gradient 1:14 or 4.1°) surfaces. Measures recorded were gait speed, cadence, step length, support base, single and double limb support duration and step length symmetry. Group and walking condition effects were assessed by two separate 2-way (group × slope) repeated measures multivariate analysis of variance.
The stroke group walked slower (p < 0.001) than the reference group for all conditions. Within-group analyses found the stroke group decreased their speed and step length when walking downhill compared to level and uphill walking (p < 0.001). In contrast, the reference group maintained speed across all walking conditions.
The findings suggest that walking on slopes affects gait speed in people with stroke and this may have implications when walking in the community.
• Although a high percentage of people achieve walking independence following a stroke, few achieve independent community mobility. • Walking on slopes is an important aspect of community mobility. • When walking down a standard gradient ramp, people with stroke reduced their speed and step length, relative to level over-ground and uphill walking. • It is recommended that attention be directed to assessment and treatment of walking on slopes as part of stroke rehabilitation, as this may have implications when walking in the community.
研究脑卒中患者在斜坡和平地上行走时的基本时空步态特征，并将其与健康匹配的成年人进行比较。
本描述性观察研究纳入了 15 名居住在社区的偏瘫步态脑卒中患者和 15 名性别、年龄和身高匹配的无损伤成年人作为参考组。在置于水平、上坡和下坡（斜坡坡度为 1:14 或 4.1°）表面的步态分析跑台上，以自身选择的速度记录基本步态时空测量值。记录的测量值包括步速、步频、步长、支撑基础、单肢和双肢支撑时间和步长对称性。通过 2 种独立的 2 因素（组×斜坡）重复测量多元方差分析评估组间和行走条件的影响。
与参考组相比，脑卒中组在所有条件下的步速均较慢（p<0.001）。组内分析发现，脑卒中组在下坡行走时的步速和步长均低于平地和上坡行走（p<0.001）。相比之下，参考组在所有行走条件下均保持了步速。
研究结果表明，斜坡行走会影响脑卒中患者的步态速度，这可能对其在社区中的行走能力产生影响。
尽管大多数脑卒中患者能实现独立行走，但只有少数人能实现独立的社区活动能力。
斜坡行走是社区活动能力的重要方面。
当人们在标准坡度的斜坡上行走时，与平地和上坡行走相比，他们会降低步速和步长。
建议将注意力集中在评估和治疗斜坡行走上，作为脑卒中康复的一部分，因为这可能对其在社区中的行走能力产生影响。
