Chow John W, Stokic Dobrivoje S
Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson Drive, Jackson, MS, 39216, USA,
Exp Brain Res. 2015 Jan;233(1):125-35. doi: 10.1007/s00221-014-4099-2. Epub 2014 Sep 17.
We compared gait using the planar law of intersegmental coordination between 14 hemorrhagic stroke subjects walking at a self-selected normal speed (56 ± 21 cm/s) and 15 age-matched healthy controls walking at a very slow speed (56 ± 19 cm/s). Sagittal plane elevation angles of the thigh, shank, and foot segments were submitted to principal component analysis. Additional outcome measures included the range of elevation angle and timing of peak elevation angle of the thigh, shank, and foot segments. The range of elevation angles at the shank and foot was significantly smaller in the paretic leg than non-paretic and control legs. Also, the peak elevation angle at the thigh occurred significantly later in the gait cycle in the paretic than control leg. Gait of both stroke and control subjects followed the planar law with the first two principal components explaining approximately 99% of the variance. However, the three-dimensional trajectory of elevation angles (gait loop) in stroke subjects deviated from the typical teardrop shape bilaterally, which was more exaggerated in the paretic leg. Compared to the non-paretic and control legs, the paretic leg showed significantly increased absolute loading of the thigh elevation angle and decreased absolute loadings of the shank and foot elevation angles on the first principal component, whereas the opposite was observed for the second principal component. Despite following the planar law, the gait of chronic stroke subjects is characterized by atypical timing of the thigh motion and disrupted intersegmental coordination of both legs.
我们比较了14名出血性中风患者以自我选择的正常速度（56±21厘米/秒）行走时与15名年龄匹配的健康对照者以非常慢的速度（56±19厘米/秒）行走时的节段间协调平面定律步态。对大腿、小腿和足部节段的矢状面仰角进行主成分分析。额外的结局指标包括大腿、小腿和足部节段的仰角范围和仰角峰值时间。患侧小腿和足部的仰角范围明显小于非患侧和对照侧。此外，患侧大腿的仰角峰值在步态周期中出现的时间明显晚于对照侧。中风患者和对照者的步态均遵循平面定律，前两个主成分解释了约99%的方差。然而，中风患者的仰角三维轨迹（步态环）双侧偏离典型的泪滴形状，在患侧更为明显。与非患侧和对照侧相比，患侧在第一主成分上大腿仰角的绝对负荷显著增加，小腿和足部仰角的绝对负荷降低，而在第二主成分上则观察到相反的情况。尽管遵循平面定律，但慢性中风患者的步态特征是大腿运动的时间不典型且双腿节段间协调中断。
