Aoki Osamu, Otani Yoshitaka, Morishita Shinichiro, Domen Kazuhisa
Faculty of Rehabilitation, Shijonawate Gakuen University, 5-11-10 Houjo, Daito, Osaka, 574-0011, Japan.
Faculty of Rehabilitation, Kobe International University, 9-1-6 Kouyocho-naka, Higashinada, Kobe, Hyogo, 658-0032, Japan.
Gait Posture. 2017 Feb;52:301-307. doi: 10.1016/j.gaitpost.2016.12.018. Epub 2016 Dec 19.
Downward gazing is commonly observed among patients after a stroke during standing or walking as they struggle to maintain equilibrium. In this study, we aimed to evaluate the effects of fixed gazing and downward gazing on trunk control ability during gait. Sixteen subjects after a stroke (age: 51.3±4.9years) and seven healthy subjects (age: 65.1±3.4years) participated in this study. Participants walked 10m at a comfortable speed while they faced forward (no gaze point), gazed forward (with a fixed gaze point), gazed downward, and gazed downward while concealing their legs. Trunk acceleration was measured using tri-axial accelerometers attached to the back of the upper (C7 spinous process) and lower (L3 spinous process) trunk. The coefficient of attenuation (CoA) of acceleration at the trunk was computed to assess trunk control ability. Results in the stroke group showed that the CoA during fixed-point and downward gazing was better than that while facing forward with no gaze point (p<0.001). In the stroke group, the CoA during gazing downward with their legs concealed was worse than that during downward gazing. Our findings indicate that patients after a stroke might use visual information for reducing their neck oscillation (C7) during fixed-point and downward gazing. Our results indicate that the visual information during downward gazing might work the same as during fixed-point gazing.
中风患者在站立或行走时努力保持平衡，常常会出现向下凝视的情况。在本研究中，我们旨在评估固定凝视和向下凝视对步态中躯干控制能力的影响。16名中风后患者（年龄：51.3±4.9岁）和7名健康受试者（年龄：65.1±3.4岁）参与了本研究。参与者以舒适的速度向前行走10米，行走时他们向前看（无凝视点）、向前凝视（有固定凝视点）、向下凝视以及在隐藏腿部的同时向下凝视。使用附着在上躯干（C7棘突）和下躯干（L3棘突）背部的三轴加速度计测量躯干加速度。计算躯干加速度的衰减系数（CoA）以评估躯干控制能力。中风组的结果表明，定点凝视和向下凝视期间的CoA优于无凝视点向前看时（p<0.001）。在中风组中，隐藏腿部向下凝视期间的CoA比向下凝视时更差。我们的研究结果表明，中风后患者在定点凝视和向下凝视期间可能会利用视觉信息来减少颈部（C7）的摆动。我们的结果表明，向下凝视期间的视觉信息可能与定点凝视期间的视觉信息作用相同。
