Menezes Kênia K, Faria Christina D, Scianni Aline A, Avelino Patrick R, Faria-Fortini Iza, Teixeira-Salmela Luci F
Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil -
Eur J Phys Rehabil Med. 2017 Feb;53(1):24-31. doi: 10.23736/S1973-9087.16.04349-5. Epub 2016 Oct 21.
Similar to the findings with the upper limbs, previous dominance of the lower limbs could also interfere with measures of impairment and activity of individuals with stroke. If this occurs, rehabilitation interventions should be planned, considering previous lower limb dominance.
To investigate the impact of having the dominant versus the non-dominant lower limb affected by the stroke on measures of impairment and activity.
Cross-sectional study.
University laboratory.
Ninety subjects with chronic stroke, divided into dominant (n=44) and non-dominant (N.=46) groups.
The sub-groups were classified according to the severity of motor impairments into mild and severe. Impairment measures included sensation, tonus, isometric strength and motor coordination, whereas activity measures included walking speed, and stair ascent/descent cadences.
The MANOVAs did not reveal any significant interactions between dominance and severity of motor impairments for both the impairment and activity models. Significant main effects of severity of motor impairments were found for both the impairment and activity models, but not for dominance. All dependent variables were significantly affected by the severity of motor impairments, but not by dominance.
The findings suggested that individuals, who had their dominant lower limb affected by the stroke, demonstrated similar impairments, than those who had the non-dominant lower limb affected. Furthermore, significant effects of severity of motor impairments, but not of dominance, were found on all measures of impairment and activity.
The findings emphasize the importance of not training the lower limbs based upon previous dominance, but giving priority to bilateral training. When both limbs are simultaneously used in tasks, the movement of the non-dominant limb improves the quality of the movement, accuracy, and speed, because bilateral training helps the unaffected side to train the affected side.
与上肢的研究结果相似，先前下肢的优势也可能干扰中风患者的损伤和活动测量。如果出现这种情况，应考虑先前下肢的优势来规划康复干预措施。
研究中风影响优势下肢与非优势下肢对损伤和活动测量的影响。
横断面研究。
大学实验室。
90名慢性中风患者，分为优势组（n = 44）和非优势组（n = 46）。
根据运动损伤的严重程度将亚组分为轻度和重度。损伤测量包括感觉、肌张力、等长肌力和运动协调性，而活动测量包括步行速度和上下楼梯节奏。
对于损伤和活动模型，多变量方差分析均未显示优势与运动损伤严重程度之间存在任何显著交互作用。在损伤和活动模型中均发现了运动损伤严重程度的显著主效应，但优势因素未显示出显著主效应。所有因变量均受运动损伤严重程度的显著影响，但不受优势因素的影响。
研究结果表明，中风影响优势下肢的个体与中风影响非优势下肢的个体表现出相似的损伤。此外，在所有损伤和活动测量中均发现了运动损伤严重程度的显著影响，而非优势因素的显著影响。
研究结果强调了不以先前的优势为基础训练下肢，而是优先进行双侧训练的重要性。当在任务中同时使用双下肢时，非优势肢体的运动会提高运动质量、准确性和速度，因为双侧训练有助于未受影响的一侧训练受影响的一侧。
