Liao Chien-Fen, Liaw Lih-Jiun, Wang Ray-Yau, Su Fong-Chin, Hsu Ar-Tyan
Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan.
Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taiwan ; Department of Rehabilitation Medicine, Kaohsiung Medical University Hospital, Taiwan.
J Phys Ther Sci. 2015 Jul;27(7):2201-6. doi: 10.1589/jpts.27.2201. Epub 2015 Jul 22.
[Purpose] The purposes of this study were to investigate differences between patients with chronic stroke and age matched healthy controls in trunk stability, by assessing the kinematics of the center of mass and moving body segments during voluntary limb and trunk movement, and the relationship between trunk stability and clinical measurements. [Subjects and Methods] Fifteen stroke patients and 15 age- and gender-matched healthy subjects participated. Each subject performed flexion of the hip and shoulder of the non-paretic or matched side as fast as possible, as well as trunk flexion and extension at a self-selected speed. A Qualisys motion system was employed to track the kinematics of the trunk and limbs. [Results] Patients presented larger mediolateral displacement of the center of mass during all limb and trunk movements, and larger velocity of center of mass during hip flexion movement. Healthy subjects showed greater movement velocity during shoulder flexion, trunk flexion and extension. Patients' clinical measurements only correlated with movement characteristics during voluntary trunk motions. [Conclusion] Trunk stability in patients with chronic stroke was compromised during voluntary trunk as well as non-paretic limb movements, and the voluntary trunk movements reflected the trunk deficits measured using clinical measurements. Rehabilitation of patients with chronic stroke should include programs to improve trunk stability.
[目的]本研究旨在通过评估在自主肢体和躯干运动过程中质心和移动身体节段的运动学,研究慢性中风患者与年龄匹配的健康对照者在躯干稳定性方面的差异,以及躯干稳定性与临床测量之间的关系。[对象与方法]15例中风患者和15例年龄及性别匹配的健康受试者参与研究。每位受试者尽可能快地进行非患侧或匹配侧髋关节和肩关节的屈曲,以及以自选速度进行躯干的屈伸。采用Qualisys运动系统跟踪躯干和四肢的运动学。[结果]在所有肢体和躯干运动过程中,患者的质心在内外侧方向上的位移更大,在髋关节屈曲运动中质心速度更大。健康受试者在肩关节屈曲、躯干屈伸过程中表现出更大的运动速度。患者的临床测量仅与自主躯干运动期间的运动特征相关。[结论]慢性中风患者在自主躯干运动以及非患侧肢体运动过程中,躯干稳定性受损,且自主躯干运动反映了通过临床测量所测得的躯干功能缺陷。慢性中风患者的康复应包括改善躯干稳定性的方案。