Kitatani Ryosuke, Ohata Koji, Sakuma Kaoru, Aga Yumi, Yamakami Natsuki, Hashiguchi Yu, Yamada Shigehito
Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Gait Posture. 2016 Mar;45:35-40. doi: 10.1016/j.gaitpost.2016.01.006. Epub 2016 Jan 12.
Increased ankle muscle coactivation during gait has frequently been observed as an adaptation strategy to compensate for postural instability in adults after stroke. However, it remains unclear whether the muscle coactivation pattern increases or decreases after balance training. The aim of this study was to investigate the immediate effects of balance practice on ankle muscle coactivation during gait in adults after stroke. Standing balance practice performed to shift as much weight anteriorly as possible in 24 participants after stroke. The forward movement distance of the center of pressure (COP) during anterior weight shifting, gait speed, and ankle muscle activities during 10-m walking tests were measured immediately before and after balance practice. Forward movement of the COP during anterior weight shifting and gait speed significantly increased after balance practice. On the paretic side, tibialis anterior muscle activity significantly decreased during the single support and second double support phases, and the coactivation index at the ankle joint during the first double support and single support phases significantly decreased after balance practice. However, there were no significant relationships between the changes in gait speed, forward movement of the COP during anterior weight shifting, and ankle muscle coactivation during the stance phase. These results suggested that ankle muscle coactivation on the paretic side during the stance phase was decreased immediately after short-term anterior weight shift practice, which was not associated with improved gait speed or forward movement of the COP during anterior weight shifting in adults after stroke.
在步态中,踝关节肌肉共同激活增加常被视为一种适应策略,以补偿中风后成年人的姿势不稳。然而,平衡训练后肌肉共同激活模式是增加还是减少仍不清楚。本研究的目的是调查平衡训练对中风后成年人步态中踝关节肌肉共同激活的即时影响。对24名中风后参与者进行站立平衡训练,使其尽可能将更多体重向前转移。在平衡训练前后立即测量前向体重转移过程中压力中心(COP)的向前移动距离、步态速度以及10米步行测试期间的踝关节肌肉活动。平衡训练后,前向体重转移过程中COP的向前移动和步态速度显著增加。在患侧,在单支撑和第二个双支撑阶段,胫骨前肌活动显著降低,在第一个双支撑和单支撑阶段,踝关节的共同激活指数在平衡训练后显著降低。然而,步态速度的变化、前向体重转移过程中COP的向前移动与站立期踝关节肌肉共同激活之间没有显著关系。这些结果表明,在短期前向体重转移训练后,患侧站立期踝关节肌肉共同激活立即降低,这与中风后成年人步态速度的改善或前向体重转移过程中COP的向前移动无关。