Huntley Andrew H, Schinkel-Ivy Alison, Aqui Anthony, Mansfield Avril
Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, Ontario M5G 2A2, Canada.
School of Physical and Health Education, Nipissing University, 100 College Drive, North Bay, Ontario P1B 8L7, Canada.
Clin Biomech (Bristol). 2017 Oct;48:97-102. doi: 10.1016/j.clinbiomech.2017.07.015. Epub 2017 Jul 31.
The feasibility of using a multiple segment (full-body) kinematic model in clinical gait assessment is difficult when considering obstacles such as time and cost constraints. While simplified gait models have been explored in healthy individuals, no such work to date has been conducted in a stroke population. The aim of this study was to quantify the errors of simplified kinematic models for chronic stroke gait assessment.
Sixteen individuals with chronic stroke (>6months), outfitted with full body kinematic markers, performed a series of gait trials. Three centre of mass models were computed: (i) 13-segment whole-body model, (ii) 3 segment head-trunk-pelvis model, and (iii) 1 segment pelvis model. Root mean squared error differences were compared between models, along with correlations to measures of stroke severity.
Error differences revealed that, while both models were similar in the mediolateral direction, the head-trunk-pelvis model had less error in the anteroposterior direction and the pelvis model had less error in the vertical direction. There was some evidence that the head-trunk-pelvis model error is influenced in the mediolateral direction for individuals with more severe strokes, as a few significant correlations were observed between the head-trunk-pelvis model and measures of stroke severity.
These findings demonstrate the utility and robustness of the pelvis model for clinical gait assessment in individuals with chronic stroke. Low error in the mediolateral and vertical directions is especially important when considering potential stability analyses during gait for this population, as lateral stability has been previously linked to fall risk.
考虑到时间和成本限制等障碍，在临床步态评估中使用多节段（全身）运动学模型存在困难。虽然已经在健康个体中探索了简化的步态模型，但迄今为止尚未在中风人群中开展此类工作。本研究的目的是量化用于慢性中风步态评估的简化运动学模型的误差。
16名慢性中风患者（>6个月）佩戴全身运动学标记物，进行了一系列步态试验。计算了三种质心模型：（i）13节段全身模型，（ii）头-躯干-骨盆3节段模型，以及（iii）骨盆1节段模型。比较了各模型之间的均方根误差差异，以及与中风严重程度测量指标的相关性。
误差差异表明，虽然两个模型在内外侧方向上相似，但头-躯干-骨盆模型在前后方向上的误差较小，而骨盆模型在垂直方向上的误差较小。有证据表明，对于中风更严重者，头-躯干-骨盆模型的误差在内外侧方向上受到影响，因为在头-躯干-骨盆模型与中风严重程度测量指标之间观察到了一些显著的相关性。
这些发现证明了骨盆模型在慢性中风患者临床步态评估中的实用性和稳健性。在考虑该人群步态期间的潜在稳定性分析时，内外侧和垂直方向上的低误差尤为重要，因为先前已将侧向稳定性与跌倒风险联系起来。
