Tanikawa Hiroki, Ohtsuka Kei, Mukaino Masahiko, Inagaki Keisuke, Matsuda Fumihiro, Teranishi Toshio, Kanada Yoshikiyo, Kagaya Hitoshi, Saitoh Eiichi
a Faculty of Rehabilitation , School of Health Sciences, Fujita Health University , Toyoake , Aichi , Japan.
b Department of Rehabilitation Medicine I , School of Medicine, Fujita Health University , Toyoake , Aichi , Japan.
Top Stroke Rehabil. 2016 Oct;23(5):311-7. doi: 10.1080/10749357.2016.1156361. Epub 2016 Mar 23.
Gait assessment is important to determine the most effective strategy to regain gait function during stroke rehabilitation. To understand the mechanisms that cause abnormal gait patterns, it is useful to objectively identify and quantify the abnormal gait patterns. Objective assessment also helps evaluate the efficacy of treatments and can be used to provide suggestions for treatment.
To evaluate the validity of quantitative indices for retropulsion of the hip, excessive hip external rotation, and excessive lateral shift of the trunk over the unaffected side in hemiplegic patients.
Forty-six healthy control subjects and 112 hemiplegic patients participated. From the 112 patients, 50 patients were selected into each abnormal gait pattern with some overlap. Participants were instructed to walk on a treadmill and were recorded using a three-dimensional motion analysis system. An index to quantify each of the three abnormal gait patterns was calculated from the three-dimensional coordinate data. The index values of patients were compared with those of healthy subjects and with the results of observational gait assessment by three physical therapists with expertise in gait analysis.
Strong correlation was observed between the index value and the median observational rating for all three abnormal gait patterns (-0.56 to -0.74). Most of the patients with an abnormal gait pattern had a higher index value than the healthy subjects.
The proposed indices are useful for clinical gait analysis. Our results encourage a more detailed analysis of hemiplegic gait using a motion analysis system.
步态评估对于确定中风康复期间恢复步态功能的最有效策略很重要。为了解导致异常步态模式的机制，客观地识别和量化异常步态模式很有用。客观评估还有助于评估治疗效果，并可用于提供治疗建议。
评估偏瘫患者中髋部后冲、髋关节过度外旋以及躯干向未受影响侧过度侧移的定量指标的有效性。
46名健康对照者和112名偏瘫患者参与研究。从112名患者中，每种异常步态模式选取50名患者，存在一些重叠。参与者被要求在跑步机上行走，并使用三维运动分析系统进行记录。根据三维坐标数据计算出量化三种异常步态模式中每种模式的指标。将患者的指标值与健康受试者的指标值以及由三位具有步态分析专业知识的物理治疗师进行的观察性步态评估结果进行比较。
在所有三种异常步态模式的指标值与观察评分中位数之间均观察到强相关性（-0.56至-0.74）。大多数具有异常步态模式的患者的指标值高于健康受试者。
所提出的指标对临床步态分析有用。我们的结果鼓励使用运动分析系统对偏瘫步态进行更详细的分析。
