Kim Woo-Sub
Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul Veteran Hospital, South Korea; Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, South Korea.
Hum Mov Sci. 2016 Oct;49:87-94. doi: 10.1016/j.humov.2016.06.004. Epub 2016 Jun 24.
This study was performed to investigate whether components from trunk progression (TP) and step length were related to step length asymmetry in walking in patients with hemiparesis. Gait analysis was performed for participants with hemiparesis and healthy controls. The distance between the pelvis and foot in the anterior-posterior axis was calculated at initial-contact. Step length was partitioned into anterior foot placement (AFP) and posterior foot placement (PFP). TP was partitioned into anterior trunk progression (ATP) and posterior trunk progression (PTP). The TP pattern and step length pattern were defined to represent intra-TP and intra-step spatial balance, respectively. Of 29 participants with hemiparesis, nine participants showed longer paretic step length, eight participants showed symmetric step length, and 12 participants showed shorter paretic step length. For the hemiparesis group, linear regression analysis showed that ATP asymmetry, AFP asymmetry, and TP patterns had significant predictability regarding step length asymmetry. Prolonged paretic ATP and shortened paretic AFP was the predominant pattern in the hemiparesis group, even in participants with symmetric step length. However, some participants showed same direction of ATP and AFP asymmetry. These findings indicate the following: (1) ATP asymmetries should be observed to determine individual characteristics of step length asymmetry, and (2) TP patterns can provide complementary information for non-paretic limb compensation.
本研究旨在调查偏瘫患者行走时躯干进展(TP)的组成部分和步长是否与步长不对称有关。对偏瘫患者和健康对照者进行了步态分析。在初始接触时计算骨盆与足部在前后轴上的距离。步长分为前足放置(AFP)和后足放置(PFP)。TP分为前躯干进展(ATP)和后躯干进展(PTP)。TP模式和步长模式分别定义为代表TP内和步内的空间平衡。在29名偏瘫患者中,9名患者患侧步长较长,8名患者步长对称,12名患者患侧步长较短。对于偏瘫组,线性回归分析表明,ATP不对称、AFP不对称和TP模式对步长不对称具有显著的预测性。患侧ATP延长和患侧AFP缩短是偏瘫组的主要模式,即使在步长对称的参与者中也是如此。然而,一些参与者表现出ATP和AFP不对称的方向相同。这些发现表明:(1)应观察ATP不对称以确定步长不对称的个体特征,(2)TP模式可为非患侧肢体代偿提供补充信息。