Chu Virginia W, Hornby T George, Schmit Brian D
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, United States.
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, United States; Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States.
Clin Neurophysiol. 2015 Feb;126(2):372-81. doi: 10.1016/j.clinph.2014.06.047. Epub 2014 Jul 11.
This study aimed to improve our understanding of static and dynamic lower extremity sensory perception and the impact of sensory impairments on the control of walking in stroke survivors.
Using a custom, real-time unloading system, we tested load perception at heel strike, mid stance and push off in 10 stroke survivors and compared their performance to 10 age-matched and 5 young adult control subjects. Dynamic load perception was based on a judgment of which leg was bearing more load, which was altered on a step by step basis. We also examined lower extremity static load perception, coordination, proprioception, balance, and gait symmetry.
The stroke survivors performed significantly worse than the control subjects in dynamic load perception, coordination, proprioception, balance and gait symmetry. Gait symmetry correlated with static and dynamic load perception measures but not with age, proprioception, coordination, and balance.
Sensory deficits related to load detection in the impaired limb could result in an increased uncertainty of limb load and a gait strategy in which stroke survivors minimize loading of the impaired limb.
This new method of measuring lower extremity dynamic load perception provides a framework for understanding gait-related sensory impairments in stroke survivors.
本研究旨在加深我们对下肢静态和动态感觉感知的理解，以及感觉障碍对中风幸存者步行控制的影响。
我们使用定制的实时卸载系统，测试了10名中风幸存者在足跟触地、站立中期和蹬离期的负荷感知，并将他们的表现与10名年龄匹配的对照受试者和5名年轻成人对照受试者进行了比较。动态负荷感知基于对哪条腿承受更多负荷的判断，该判断在逐步基础上进行改变。我们还检查了下肢静态负荷感知、协调性、本体感觉、平衡和步态对称性。
中风幸存者在动态负荷感知、协调性、本体感觉、平衡和步态对称性方面的表现明显比对照受试者差。步态对称性与静态和动态负荷感知测量相关，但与年龄、本体感觉、协调性和平衡无关。
与受损肢体负荷检测相关的感觉缺陷可能导致肢体负荷不确定性增加，以及中风幸存者尽量减少受损肢体负荷的步态策略。
这种测量下肢动态负荷感知的新方法为理解中风幸存者与步态相关的感觉障碍提供了一个框架。
