Bonnyaud Céline, Pradon Didier, Bensmail Djamel, Roche Nicolas
Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Laboratoire d'analyse du mouvement, Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380, Garches, France.
Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular diseases, UVSQ, CIC 1429, APHP Service de médecine physique et réadaptation, Hôpital Raymond Poincaré, 92380, Garches, France.
PLoS One. 2015 Oct 15;10(10):e0140317. doi: 10.1371/journal.pone.0140317. eCollection 2015.
The Timed Up and Go (TUG) test is often used to estimate risk of falls. Foot clearance and displacement of the center of mass (COM), which are related to risk of tripping and dynamic stability have never been evaluated during the TUG. Accurate assessment of these parameters using instrumented measurements would provide a comprehensive assessment of risk of falls in hemiparetic patients. The aims of this study were to analyze correlations between TUG performance time and displacement of the COM and foot clearance in patients with stroke-related hemiparesis and healthy subjects during the walking and turning sub-tasks of the TUG and to compare these parameters between fallers and non-fallers.
29 hemiparetic patients and 25 healthy subjects underwent three-dimensional gait analysis during the TUG test. COM and foot clearance were analyzed during the walking and turning sub-tasks of the TUG.
Lateral displacement of the COM was greater and faster during the walking sub-tasks and vertical displacement of the COM was greater during the turn in the patients compared to the healthy subjects (respectively p<0.01 and p<0.05). Paretic foot clearance was greater during walking and displacement of the COM was slower during the turn in the patients (p<0.01). COM displacement and velocity during the turn were correlated with TUG performance in the patients, however, vertical COM displacement was not. These correlations were significant in the healthy subjects. There were no differences between COM parameters or foot clearance in fallers and non-fallers.
Hemiparetic patients are less stable than healthy subjects, but compensate with a cautious gait to avoid tripping. Instrumented analysis of the TUG test appears relevant for the assessment of dynamic stability in hemiparetic patients, providing more information than straight-line gait.
定时起立行走（TUG）测试常用于评估跌倒风险。在TUG测试过程中，从未对与绊倒风险和动态稳定性相关的足部间隙和质心（COM）位移进行过评估。使用仪器测量准确评估这些参数将能全面评估偏瘫患者的跌倒风险。本研究的目的是分析中风相关性偏瘫患者和健康受试者在TUG测试的行走和转身子任务中TUG执行时间与COM位移和足部间隙之间的相关性，并比较跌倒者和非跌倒者之间的这些参数。
29名偏瘫患者和25名健康受试者在TUG测试期间接受三维步态分析。在TUG测试的行走和转身子任务中分析COM和足部间隙。
与健康受试者相比，患者在行走子任务期间COM的横向位移更大且更快，在转身时COM的垂直位移更大（分别为p<0.01和p<0.05）。患者在行走期间患侧足部间隙更大，在转身时COM的位移更慢（p<0.01）。患者在转身时COM位移和速度与TUG执行情况相关，然而，COM垂直位移则不然。这些相关性在健康受试者中显著。跌倒者和非跌倒者之间的COM参数或足部间隙没有差异。
偏瘫患者比健康受试者稳定性差，但通过谨慎步态进行代偿以避免绊倒。TUG测试的仪器分析似乎与评估偏瘫患者的动态稳定性相关，比直线步态能提供更多信息。
