Hama Seiji, Ohtsubo Masafumi, Nishiwaki Tsuyoshi, Miura Ayu, Sanemasu Mie, Shimada Noboru, Fujimoto Yukio, Tao Saori, Suzuki Takahiro, Hara Daisuke, Iino Eriko, Kawahama Shiori, Sato Daisuke
Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan Department of Neurosurgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
Ohtsubo Prosthetics and Orthotics MFG. Co., Yamaguchi, Japan.
Prosthet Orthot Int. 2015 Oct;39(5):405-13. doi: 10.1177/0309364614536763. Epub 2014 Jun 12.
Many stroke and neuromuscular patients with paraplegia or severe hemiparesis cannot control trunk balance.
To support the pelvis/hip of paresis patients, a new pelvic/hip support system was developed bearing a convex pressing member placed over the post-trochanteric groove, a cutaneous landmark sited on the lateral portion of the gluteus maximus muscle and indicating the posterior aspect of the greater trochanter.
Preliminary study.
Stance control differences in two paretic patients (Guillain-Barré syndrome and stroke sequelae) with or without post-trochanteric groove support were examined. The contact pressure on the post-trochanteric groove was examined in eight healthy volunteers using an impact force sensor. The pelvic-lumbar movement was also examined using three-dimensional motion analysis, and the gluteus muscles activity was evaluated using surface electromyography.
Without post-trochanteric groove support, total three-dimensional displacement of the sacral marker was longer in the paresis patients than in normal controls, while post-trochanteric groove support decreased this distance. Post-trochanteric groove support provided compression pressure on the post-trochanteric groove, and all subjects showed a more upright trunk position, providing more anterior pelvic tilting. Six of eight subjects showed increased lumbar lordosis. Five of eight subjects showed gluteus maximus and/or gluteus medius muscle activation.
The mechanisms of post-trochanteric groove support were suggested to be spino-pelvic coordination and gluteal muscle activation.
The post-trochanteric groove is a cutaneous landmark located behind the pelvis/hip joint. Applying pressure to the post-trochanteric groove from behind pushes the trunk to adopt a more upright position, leading to improved stance control. Underlining mechanisms appear to be spino-pelvic coordination and gluteal muscle activation.
许多中风和神经肌肉疾病导致截瘫或严重偏瘫的患者无法控制躯干平衡。
为了支撑麻痹患者的骨盆/臀部，开发了一种新的骨盆/臀部支撑系统，该系统带有一个放置在转子后沟上方的凸形按压部件，转子后沟是位于臀大肌外侧部分的一个皮肤标志，指示大转子的后方。
初步研究。
检查了两名麻痹患者（吉兰-巴雷综合征和中风后遗症）在有或没有转子后沟支撑情况下的站立控制差异。使用冲击力传感器检查了八名健康志愿者转子后沟上的接触压力。还使用三维运动分析检查了骨盆-腰椎运动，并使用表面肌电图评估了臀肌活动。
在没有转子后沟支撑的情况下，麻痹患者骶骨标志物的三维总位移比正常对照组更长，而转子后沟支撑减小了这一距离。转子后沟支撑在转子后沟上提供了压缩压力，所有受试者的躯干位置都更加直立，骨盆前倾增加。八名受试者中有六名腰椎前凸增加。八名受试者中有五名臀大肌和/或臀中肌激活。
转子后沟支撑的机制被认为是脊柱-骨盆协调和臀肌激活。
转子后沟是位于骨盆/髋关节后方的一个皮肤标志。从后面向转子后沟施加压力会推动躯干采取更直立的姿势，从而改善站立控制。潜在机制似乎是脊柱-骨盆协调和臀肌激活。
