Tyrell Christine M, Helm Erin, Reisman Darcy S
Thomas Jefferson University, School of Health Professions, Department of Physical Therapy, 901 Walnut Street, Room 516, Philadelphia, PA 19107, USA.
University of Delaware, Department of Physical Therapy, USA; University of Delaware, Graduate Program in Biomechanics and Movement Science, USA.
J Biomech. 2015 Aug 20;48(11):2849-57. doi: 10.1016/j.jbiomech.2015.04.027. Epub 2015 Apr 22.
Stroke survivors without cerebellar involvement retain the ability to adapt to the split-belt treadmill; however it has been suggested that their rate of adaptation may be slowed compared to those who are neurologically intact. Depending on limb placement, the split-belt treadmill can be configured to either exaggerate baseline asymmetry, or reduce it, which may affect the behavior of adaptation or de-adaptation. The objectives of this study were to characterize the rate and magnitude of locomotor (de)adaptation in chronic stroke survivors compared to healthy matched subjects, and to evaluate whether exaggeration or reduction of baseline asymmetry impact the responses. Seventeen stroke survivors and healthy subjects completed 10min of split-belt treadmill walking, then 5min of tied-belt walking. Stroke survivors completed this once with each leg on the fast belt. Magnitude and rate of (de)adaptation were evaluated for step length and limb phase asymmetry. There were no differences between the groups with the exception of the reduced step length asymmetry configuration, in which case there was a significantly reduced magnitude (p≤0.000) and rate (p=0.011) of adaptation when compared to controls. There was a similar trend observed during post-adaptation for the exaggerated asymmetry group. The rate and magnitude of locomotor (de)adaptation is similar between chronic stroke survivors and neurologically intact controls, except when the adaptation or de-adaptation response would take the stroke survivors away from a symmetric step length pattern. This suggests that there may be some benefit to symmetry that is recognized by the system.
没有小脑受累的中风幸存者保留了适应分带跑步机的能力；然而，有人认为与神经功能正常的人相比，他们的适应速度可能会减慢。根据肢体放置情况，分带跑步机可以配置为要么夸大基线不对称性，要么减少基线不对称性，这可能会影响适应或去适应行为。本研究的目的是描述慢性中风幸存者与健康匹配受试者相比的运动（去）适应速度和幅度，并评估基线不对称性的夸大或减少是否会影响反应。17名中风幸存者和健康受试者完成了10分钟的分带跑步机行走，然后是5分钟的绑带行走。中风幸存者每条腿在快速带上各完成一次。对步长和肢体相位不对称性的（去）适应幅度和速度进行了评估。除了步长不对称性降低的配置外，两组之间没有差异，在这种情况下，与对照组相比，适应幅度（p≤0.000）和速度（p=0.011）显著降低。在适应后，夸大不对称性组也观察到了类似的趋势。慢性中风幸存者和神经功能正常的对照组之间的运动（去）适应速度和幅度相似，除非适应或去适应反应会使中风幸存者偏离对称步长模式。这表明系统可能认识到对称性有一些好处。
