Ustinova Ksenia I, Langenderfer Joseph E, Balendra Nilanthy
Doctoral Program in Physical Therapy, Central Michigan University, Mt. Pleasant, MI, USA.
School of Engineering and Technology, Central Michigan University, Mt. Pleasant, MI, USA.
Hum Mov Sci. 2017 Apr;52:45-54. doi: 10.1016/j.humov.2017.01.001. Epub 2017 Jan 20.
The current study investigated interlimb coordination in individuals with traumatic brain injury (TBI) during overground walking. The study involved 10 participants with coordination, balance, and gait abnormalities post-TBI, as well as 10 sex- and age-matched healthy control individuals. Participants walked 12m under two experimental conditions: 1) at self-selected comfortable walking speeds; and 2) with instructions to increase the amplitude and out-of-phase coordination of arm swinging. The gait was assessed with a set of spatiotemporal and kinematic parameters including the gait velocity, step length and width, double support time, lateral displacement of the center of mass, the amplitude of horizontal trunk rotation, and angular motions at shoulder and hip joints in sagittal plane. Interlimb coordination (coupling) was analyzed as the relative phase angles between the left and right shoulders, hips, and contralateral shoulders and hips, with an ideal out-of-phase coupling of 180° and ideal in-phase coupling of 0°. The TBI group showed much less interlimb coupling of the above pairs of joint motions than the control group. When participants were required to increase and synchronize arm swinging, coupling between shoulder and hip motions was significantly improved in both groups. Enhanced arm swinging was associated with greater hip and shoulder motion amplitudes, and greater step length. No other significant changes in spatiotemporal or kinematic gait characteristics were found in either group. The results suggest that arm swinging may be a gait parameter that, if controlled properly, can improve interlimb coordination during overground walking in patients with TBI.
本研究调查了创伤性脑损伤（TBI）患者在地面行走过程中的肢体间协调性。该研究纳入了10名TBI后存在协调、平衡和步态异常的参与者，以及10名性别和年龄匹配的健康对照个体。参与者在两种实验条件下行走12米：1）以自我选择的舒适步行速度；2）按照指令增加摆臂幅度和异相协调性。使用一组时空和运动学参数评估步态，包括步态速度、步长和步宽、双支撑时间、质心横向位移、水平躯干旋转幅度以及矢状面内肩关节和髋关节的角运动。肢体间协调性（耦合）被分析为左右肩、髋以及对侧肩和髋之间的相对相位角，理想的异相耦合为180°，理想的同相耦合为0°。TBI组上述关节运动对之间的肢体间耦合比对照组少得多。当要求参与者增加并同步摆臂时，两组的肩髋运动耦合均有显著改善。增强的摆臂与更大的髋部和肩部运动幅度以及更长的步长相关。两组在时空或运动学步态特征方面均未发现其他显著变化。结果表明，摆臂可能是一个步态参数，如果控制得当，可以改善TBI患者在地面行走过程中的肢体间协调性。
