Tomita Yosuke, Usuda Shigeru
Department of Rehabilitation, Harunaso Hospital.
J Phys Ther Sci. 2013 May;25(5):539-44. doi: 10.1589/jpts.25.539. Epub 2013 Jun 29.
[Purpose] We compared ankle temporal motor coordination between stroke, spinal disease and healthy elderly groups, and investigated the relationship between motor impairments and gait speed. [Subjects] Twenty-four patients with stroke, 19 post-operative spinal disease patients and 17 healthy elderly subjects participated. [Methods] Ankle temporal motor coordination of the three groups was assessed using the simple reaction time, the foot-tapping test, and a rhythm task. Rhythm error and rhythm variation were analyzed using the results of the rhythm task. Isometric muscle strength, spasticity, muscle stiffness, somatosensory and 10-m gait speed of the stroke and spinal disease subjects were also measured. [Results] Only the stroke group showed significant reductions in temporal accuracy and consistency in the rhythm task. Simple reaction time and the rhythm task were significantly poorer in the stroke group, whereas the foot-tapping test was not. Stepwise multiple regression analysis indicated gait speed was explained by rhythm error and plantarflexor strength in the stroke group, and rhythm error and simple reaction time in the spinal disease group. [Conclusion] Poor performance in simple reaction time and the rhythm task in the stroke group suggest these tasks are controlled by the supraspinal central nervous system. Negative features, particularly motor coordination, are more associated with gait speed than positive features.
[目的]我们比较了中风组、脊柱疾病组和健康老年组之间的踝关节时间运动协调性，并研究了运动障碍与步态速度之间的关系。[对象]24例中风患者、19例脊柱疾病术后患者和17例健康老年受试者参与研究。[方法]使用简单反应时间、足部敲击试验和节奏任务对三组的踝关节时间运动协调性进行评估。利用节奏任务的结果分析节奏误差和节奏变化。还测量了中风和脊柱疾病受试者的等长肌力、痉挛、肌肉僵硬度、体感和10米步态速度。[结果]只有中风组在节奏任务中的时间准确性和一致性显著降低。中风组的简单反应时间和节奏任务明显较差，而足部敲击试验则不然。逐步多元回归分析表明，中风组的步态速度由节奏误差和跖屈肌力量解释，脊柱疾病组的步态速度由节奏误差和简单反应时间解释。[结论]中风组在简单反应时间和节奏任务中的表现不佳表明这些任务由脊髓上中枢神经系统控制。消极特征，尤其是运动协调性，比积极特征与步态速度的相关性更强。
