Zhu Yulian, Zhou Chaosheng, Liu Yu, Liu Jue, Jin Jiaran, Zhang Shengnian, Bai Yulong, Huang Dequan, Zhu Bing, Xu Yiming, Wu Yi
a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China ;
b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China ;
Disabil Rehabil. 2016 Sep;38(19):1893-9. doi: 10.3109/09638288.2015.1107775. Epub 2016 Jan 4.
This study aimed to qualify the improvements of modified constraint-induced movement therapy (m-CIMT) on the lower limb of stroke patients via assessing the centre of mass (COM) displacement and the basic gait parameters.
A total of 22 hemiplegic patients after stroke with first-time clinical cerebral infarction or haemorrhagic cerebrovascular accident were included in this study from May to December, 2014. The patients were randomly divided into m-CIMT group and the conventional therapy group (control group), and received corresponding training for five days/week for four weeks. The COM displacement and gait parameters were assessed by three-dimensional segmental kinematics method in pre-intervention and post- intervention therapy.
After four weeks of m-CIMT, the COM displacement on sagittal plane of paretic leg during stance phase was increased (pre: 91.04 ± 4.39 cm, post: 92.38 ± 4.58 cm, p < 0.05) and swing range of frontal plane was remarkably decreased (pre: 10.15 ± 3.05 cm, post: 7.83 ± 1.90 cm, p < 0.001). Meantime, the normalised swing range of COM in m-CIMT was superior to that in control group. Moreover, the gait parameters, including velocity (0.27 m/s), step width (0.10 m), step length (0.22 m) and swing time percentage (29.80%), were significantly improved by post-interventions of m-CIMT (p < 0.05).
The m-CIMT intervention improves the COM displacement in sagittal and frontal plane, as well as gait parameters. These suggest that m-CIMT intervention may be feasible and effective for the rehabilitation of hemiplegic gait. Implications for Rehabilitation Segmental kinematics method was used to estimate the displacement of the COM. m-CIMT interventions improved the COM displacement of patients after stroke. m-CIMT interventions improved the hemiplegic gait parameters.
本研究旨在通过评估质心（COM）位移和基本步态参数，验证改良强制性运动疗法（m-CIMT）对中风患者下肢的改善效果。
2014年5月至12月，本研究共纳入22例首次发生临床脑梗死或出血性脑血管意外的中风后偏瘫患者。患者被随机分为m-CIMT组和传统治疗组（对照组），并接受相应训练，每周5天，共4周。在干预前和干预后治疗中，采用三维节段运动学法评估COM位移和步态参数。
经过4周的m-CIMT治疗，患侧腿在站立期矢状面的COM位移增加（干预前：91.04±4.39cm，干预后：92.38±4.58cm，p<0.05），额状面摆动范围显著减小（干预前：10.15±3.05cm，干预后：7.83±1.90cm，p<0.001）。同时，m-CIMT组COM的标准化摆动范围优于对照组。此外，m-CIMT干预后，步态参数，包括速度（0.27m/s）、步宽（0.10m）、步长（0.22m）和摆动时间百分比（29.80%）均有显著改善（p<0.05）。
m-CIMT干预可改善矢状面和额状面的COM位移以及步态参数。这些表明m-CIMT干预对于偏瘫步态的康复可能是可行且有效的。康复启示采用节段运动学法估计COM的位移。m-CIMT干预改善了中风后患者的COM位移。m-CIMT干预改善了偏瘫步态参数。
