Wright Rachel L, Bevins Joseph W, Pratt David, Sackley Catherine M, Wing Alan M
School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK; School of Psychology, University of Birmingham, Birmingham, UK.
Institute of Sport and Exercise Science, University of Worcester , Worcester , UK.
Front Neurol. 2016 Jun 1;7:84. doi: 10.3389/fneur.2016.00084. eCollection 2016.
Cerebellar stroke typically results in increased variability during walking. Previous research has suggested that auditory cueing reduces excessive variability in conditions such as Parkinson's disease and post-stroke hemiparesis. The aim of this case report was to investigate whether the use of a metronome cue during walking could reduce excessive variability in gait parameters after a cerebellar stroke. An elderly female with a history of cerebellar stroke and recurrent falling undertook three standard gait trials and three gait trials with an auditory metronome. A Vicon system was used to collect 3-D marker trajectory data. The coefficient of variation was calculated for temporal and spatial gait parameters. SDs of the joint angles were calculated and used to give a measure of joint kinematic variability. Step time, stance time, and double support time variability were reduced with metronome cueing. Variability in the sagittal hip, knee, and ankle angles were reduced to normal values when walking to the metronome. In summary, metronome cueing resulted in a decrease in variability for step, stance, and double support times and joint kinematics. Further research is needed to establish whether a metronome may be useful in gait rehabilitation after cerebellar stroke and whether this leads to a decreased risk of falling.
小脑中风通常会导致行走过程中的变异性增加。先前的研究表明，听觉提示可减少帕金森病和中风后偏瘫等情况下的过度变异性。本病例报告的目的是研究步行过程中使用节拍器提示是否能减少小脑中风后步态参数的过度变异性。一名有小脑中风病史且反复跌倒的老年女性进行了三次标准步态试验和三次使用听觉节拍器的步态试验。使用Vicon系统收集三维标记轨迹数据。计算了时间和空间步态参数的变异系数。计算关节角度的标准差并用于衡量关节运动变异性。节拍器提示可减少步长时间、站立时间和双支撑时间的变异性。按照节拍器行走时，矢状面髋关节、膝关节和踝关节角度的变异性降低至正常水平。总之，节拍器提示可减少步长、站立和双支撑时间以及关节运动学的变异性。需要进一步研究以确定节拍器是否对小脑中风后的步态康复有用，以及这是否会降低跌倒风险。
