Mohammadi Roghayeh, Talebian Saeed, Phadke Chetan P, Yekaninejad Mir Saeed, Hadian Mohammad-Reza
Physical Therapy Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran.
Spasticity Research Program, West Park Healthcare Centre, York, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada.
Arch Phys Med Rehabil. 2016 Mar;97(3):445-53. doi: 10.1016/j.apmr.2015.10.088. Epub 2015 Oct 28.
To examine the effects of walking on a treadmill at varying gradients and speeds on ankle muscle activation in stroke survivors, and to compare the effect of increasing speed on plantarflexor muscle activity in participants grouped according to spasticity severity.
Within-subject and cross-sectional design. Participants walked on a standard treadmill at 3 different inclines (0°, 3°, 6°) and speeds (self-selected, self-selected+20%, self selected+40%).
University laboratory.
A convenience sample of stroke survivors (N=19; 13 men, 6 women) available in university clinics.
Not applicable.
Electromyographic activity of medial gastrocnemius (MG) and tibialis anterior (TA) muscles at push-off phase of the gait.
Paretic MG muscle activity increased (but TA did not change) at faster speeds irrespective of the incline (P<.05). In contrast, MG muscle activity increased at a higher incline in the nonparetic side (P<.05), but not in the paretic side (P>.05). In the high-spasticity subgroup (Tardieu Scale ≥ 2), paretic MG activity increased as walking speed increased (P=.004).
Stroke survivors appear to use distinct muscle activation strategies on the paretic and nonparetic sides in response to different walking speeds and inclines. Our data indicates that individuals with stroke can be safely trained on a treadmill to walk 20% to 40% above the self-selected pace to improve MG output without adversely affecting TA output. The speed-dependent characteristic of spasticity may help generate greater MG activity during push-off.
研究在不同坡度和速度的跑步机上行走对中风幸存者踝关节肌肉激活的影响，并比较根据痉挛严重程度分组的参与者中，速度增加对跖屈肌肌肉活动的影响。
受试者内和横断面设计。参与者在标准跑步机上以3种不同坡度（0°、3°、6°）和速度（自我选择速度、自我选择速度+20%、自我选择速度+40%）行走。
大学实验室。
从大学诊所选取的中风幸存者便利样本（N = 19；13名男性，6名女性）。
不适用。
步态蹬离期腓肠肌内侧头（MG）和胫骨前肌（TA）的肌电图活动。
无论坡度如何，患侧MG肌肉活动在速度加快时增加（但TA无变化）（P <.05）。相比之下，非患侧MG肌肉活动在坡度较高时增加（P <.05），而患侧则无增加（P >.05）。在高痉挛亚组（Tardieu量表≥2）中，患侧MG活动随行走速度增加而增加（P =.004）。
中风幸存者在患侧和非患侧似乎采用不同的肌肉激活策略来应对不同的行走速度和坡度。我们的数据表明，中风患者可以在跑步机上安全地进行训练，以高于自我选择速度20%至40%的速度行走，以提高MG输出，而不会对TA输出产生不利影响。痉挛的速度依赖性特征可能有助于在蹬离期产生更大的MG活动。
