Vistamehr Arian, Kautz Steven A, Bowden Mark G, Neptune Richard R
Motion Analysis Center, Brooks Rehabilitation Hospital, Jacksonville, FL, USA.
Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Health Sciences & Research and Division of Physical Therapy, Medical University of South Carolina, Charleston, SC, USA.
J Biomech. 2016 Feb 8;49(3):396-400. doi: 10.1016/j.jbiomech.2015.12.047. Epub 2016 Jan 8.
Mediolateral balance control during walking is a challenging task in post-stroke hemiparetic individuals. To detect and treat dynamic balance disorders, it is important to assess balance using reliable methods. The Berg Balance Scale (BBS), Dynamic Gait Index (DGI), margin-of-stability (MoS), and peak-to-peak range of angular-momentum (H) are some of the most commonly used measures to assess dynamic balance and fall risk in clinical and laboratory settings. However, it is not clear if these measures lead to similar conclusions. Thus, the purpose of this study was to assess dynamic balance in post-stroke hemiparetic individuals using BBS, DGI, MoS and the range of H and determine if these measure are correlated. BBS and DGI were collected from 19 individuals post-stroke. Additionally, kinematic and kinetic data were collected while the same individuals walked at their self-selected speed. MoS and the range of H were calculated in the mediolateral direction for each participant. Correlation analyses revealed moderate associations between all measures. Overall, a higher range of angular-momentum was associated with a higher MoS, wider step width and lower BBS and DGI scores, indicating poor balance control. Further, only the MoS from the paretic foot placement, but not the nonparetic foot, correlated with the other balance measures. Although moderate correlations existed between all the balance measures, these findings do not necessarily advocate the use of a single measure as each test may assess different constructs of dynamic balance. These findings have important implications for the use and interpretation of dynamic balance assessments.
中风后偏瘫患者行走过程中的内外侧平衡控制是一项具有挑战性的任务。为了检测和治疗动态平衡障碍,使用可靠的方法评估平衡非常重要。伯格平衡量表(BBS)、动态步态指数(DGI)、稳定裕度(MoS)和角动量峰峰值范围(H)是临床和实验室环境中评估动态平衡和跌倒风险最常用的一些指标。然而,尚不清楚这些指标是否会得出相似的结论。因此,本研究的目的是使用BBS、DGI、MoS和H范围评估中风后偏瘫患者的动态平衡,并确定这些指标是否相关。从19名中风后患者中收集了BBS和DGI数据。此外,在这些患者以自选速度行走时收集了运动学和动力学数据。计算了每位参与者在内外侧方向上的MoS和H范围。相关性分析显示所有指标之间存在中度关联。总体而言,角动量范围越大,MoS越高,步幅越宽,BBS和DGI得分越低,表明平衡控制较差。此外,只有患侧足着地时的MoS与其他平衡指标相关,而非患侧足的MoS则不然。尽管所有平衡指标之间存在中度相关性,但这些发现并不一定提倡使用单一指标,因为每个测试可能评估动态平衡的不同结构。这些发现对动态平衡评估的使用和解释具有重要意义。