School of Electrical Engineering, University of Belgrade, Belgrade, Serbia Tecnalia Serbia Ltd., Belgrade, Serbia.
NeuroRehabilitation. 2013;33(3):491-501. doi: 10.3233/NRE-130982.
The main clinical measures of walking recovery in stroke patients were compared for training assisted by Walkaround® postural support (WPS) and conventional (CON) support by a cane/therapist.
We attributed the differences between the trainings to modified muscular synergies that occurred during assistance by WPS.
We studied the muscle activities of the primary knee and ankle joint movers in the paretic and non-paretic legs of sub-acute stroke patients during assisted walking with WPS and CON. Recorded signals were compared to normative data that were recorded during speed-matched gait trials in healthy subjects. The specific measures were the relative contribution of individual muscles, levels of cocontraction, and the timing of the maximum electromyography (EMG) activity during the walking sessions.
We found that, for most patients, the individual contribution of muscles were more similar to the healthy with the WPS assistance. In parallel, the cocontraction of the rectus femoris muscles in both legs was lower (by up to 39 %) during walking assisted by WPS than by cane/therapist gait support); the results from this case series (10 patients) showed that WPS might be the superior training scheme.
These findings indicated that assistance by WPS changed the motor control output relative to CON assistance in most patients.
本研究旨在对比分析使用 Walkaround®姿势支持（WPS）和传统手杖/治疗师支持（CON）辅助步行训练对脑卒中患者步行恢复的主要临床测量结果。
我们认为 WPS 辅助训练与 CON 辅助训练之间的差异与肌肉协同作用的改变有关。
本研究纳入亚急性期脑卒中患者，比较了 WPS 和 CON 辅助步行训练时，患侧和健侧下肢主要膝关节和踝关节运动肌的肌肉活动。记录的信号与健康受试者在速度匹配步态试验中记录的正常数据进行了比较。具体的测量指标包括：个体肌肉的相对贡献、协同收缩水平以及步行过程中肌电图（EMG）活动的最大时间。
我们发现，对于大多数患者来说，WPS 辅助时肌肉的个体贡献更接近健康人。同时，WPS 辅助步行时，双侧股直肌的协同收缩（低至 39%）低于 CON 辅助（这是一项来自 10 名患者的病例系列研究结果）；WPS 可能是一种更优越的训练方案。
这些发现表明，与 CON 辅助相比，WPS 辅助改变了大多数患者的运动控制输出。
