Lewek Michael D, Bradley Claire E, Wutzke Clinton J, Zinder Steven M
Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, and with the Interdisciplinary Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
J Appl Biomech. 2014 Feb;30(1):31-6. doi: 10.1123/jab.2012-0208. Epub 2013 May 13.
Falls are common after stroke and often attributed to poor balance. Falls often occur during walking, suggesting that walking patterns may induce a loss of balance. Gait after stroke is frequently spatiotemporally asymmetric, which may decrease balance. The purpose of this study is to determine the relationship between spatiotemporal gait asymmetry and balance control. Thirty-nine individuals with chronic stroke walked at comfortable and fast speeds to calculate asymmetry ratios for step length, stance time, and swing time. Balance measures included the Berg Balance Scale, step width during gait, and the weight distribution between legs during standing. Correlational analyses determined the relationships between balance and gait asymmetry. At comfortable and fast gait speeds, step width was correlated with stance time and swing time asymmetries (r = 0.39-0.54). Berg scores were correlated with step length and swing time asymmetries (r = -0.36 to -0.63). During fast walking, the weight distribution between limbs was correlated with stance time asymmetry (r = -0.41). Spatiotemporal gait asymmetry was more closely related to balance measures involving dynamic tasks than static tasks, suggesting that gait asymmetry may be related to the high number of falls poststroke. Further study to determine if rehabilitation that improves gait asymmetry has a similar influence on balance is warranted.
中风后跌倒很常见，通常归因于平衡能力差。跌倒常发生在行走过程中，这表明行走模式可能会导致平衡丧失。中风后的步态在时空上经常不对称，这可能会降低平衡能力。本研究的目的是确定时空步态不对称与平衡控制之间的关系。39名慢性中风患者以舒适和快速的速度行走，以计算步长、站立时间和摆动时间的不对称比率。平衡测量包括伯格平衡量表、步态中的步宽以及站立时双腿之间的重量分布。相关性分析确定了平衡与步态不对称之间的关系。在舒适和快速的步态速度下，步宽与站立时间和摆动时间不对称相关（r = 0.39 - 0.54）。伯格评分与步长和摆动时间不对称相关（r = -0.36至-0.63）。在快速行走时，肢体之间的重量分布与站立时间不对称相关（r = -0.41）。时空步态不对称与涉及动态任务的平衡测量比与静态任务的平衡测量关系更密切，这表明步态不对称可能与中风后大量跌倒有关。有必要进一步研究确定改善步态不对称的康复训练是否对平衡有类似的影响。
