Bonnyaud Céline, Pradon Didier, Vaugier Isabelle, Vuillerme Nicolas, Bensmail Djamel, Roche Nicolas
Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular Diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380 Garches, France.
Inserm Unit 1179, Team 3: Technologies and Innovative Therapies Applied to Neuromuscular Diseases, UVSQ, APHP Service de physiologie et d'exploration fonctionnelle, Hôpital Raymond Poincaré, 92380 Garches, France.
Gait Posture. 2016 Sep;49:258-263. doi: 10.1016/j.gaitpost.2016.06.023. Epub 2016 Jun 18.
Understanding locomotor behavior is important to guide rehabilitation after stroke. This study compared lower-limb kinematics during the walking and turning sub-tasks of the Timed Up and Go (TUG) test in stroke patients and healthy subjects. We also determined the parameters which explain TUG sub-task performance time in healthy subjects. Biomechanical parameters were recorded during the TUG in standardized conditions in 25 healthy individuals and 29 patients with chronic stroke using a 3D motion-analysis system. Parameters were compared between groups and a stepwise regression was used to indicate parameters which explained performance time in the healthy subjects. The percentage difference in step length between the last and first steps was calculated, during walking sub-tasks for each group. Speed, cadence, step length, percentage paretic single support phase, percentage non-paretic swing phase, peak hip extension, knee flexion and ankle dorsiflexion were significantly reduced in the Stroke group compared to the Healthy group (p<0.05). In the Healthy group, step length and cadence explained 91% of variance for Go and 86% for Return (walking sub-tasks), and none of the parameters explained the Turn. Previous study in patients with stroke showed that the same parameters explained the variance during the walking sub-tasks and balance-related parameters explained the Turn. The present results showed that step length was differently modulated in each group. Thus the locomotor behavior of patients with stroke during obstacle circumvention is quite specific in light of the results obtained in healthy subjects.
了解运动行为对于指导中风后的康复很重要。本研究比较了中风患者和健康受试者在定时起立行走（TUG）测试的行走和转弯子任务中的下肢运动学。我们还确定了解释健康受试者TUG子任务执行时间的参数。使用3D运动分析系统，在标准化条件下对25名健康个体和29名慢性中风患者进行TUG测试时记录生物力学参数。比较两组之间的参数，并使用逐步回归来指出解释健康受试者执行时间的参数。计算每组在行走子任务期间最后一步和第一步之间步长的百分比差异。与健康组相比，中风组的速度、步频、步长、患侧单支撑期百分比、健侧摆动期百分比、髋关节伸展峰值、膝关节屈曲和踝关节背屈均显著降低（p<0.05）。在健康组中，步长和步频解释了“走”子任务91%的方差和“返回”（行走子任务）86%的方差，没有参数能解释“转弯”子任务。先前对中风患者的研究表明，相同的参数解释了行走子任务期间的方差，而与平衡相关的参数解释了“转弯”子任务。目前的结果表明，每组的步长调节方式不同。因此，根据在健康受试者中获得的结果，中风患者在绕过障碍物时的运动行为非常特殊。
