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施加骨盆矫正力会促使偏瘫侧腿被迫运动,并改善中风后个体在跑步机行走过程中偏瘫侧腿的肌电图活动。

Applying a pelvic corrective force induces forced use of the paretic leg and improves paretic leg EMG activities of individuals post-stroke during treadmill walking.

作者信息

Hsu Chao-Jung, Kim Janis, Tang Rongnian, Roth Elliot J, Rymer William Z, Wu Ming

机构信息

Legs and Walking Lab, Shirley Ryan Abilitylab, Chicago, IL, USA.

Legs and Walking Lab, Shirley Ryan Abilitylab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.

出版信息

Clin Neurophysiol. 2017 Oct;128(10):1915-1922. doi: 10.1016/j.clinph.2017.07.409. Epub 2017 Jul 31.

Abstract

OBJECTIVE

To determine whether applying a mediolateral corrective force to the pelvis during treadmill walking would enhance muscle activity of the paretic leg and improve gait symmetry in individuals with post-stroke hemiparesis.

METHODS

Fifteen subjects with post-stroke hemiparesis participated in this study. A customized cable-driven robotic system based over a treadmill generated a mediolateral corrective force to the pelvis toward the paretic side during early stance phase. Three different amounts of corrective force were applied. Electromyographic (EMG) activity of the paretic leg, spatiotemporal gait parameters and pelvis lateral displacement were collected.

RESULTS

Significant increases in integrated EMG of hip abductor, medial hamstrings, soleus, rectus femoris, vastus medialis and tibialis anterior were observed when pelvic corrective force was applied, with pelvic corrective force at 9% of body weight inducing greater muscle activity than 3% or 6% of body weight. Pelvis lateral displacement was more symmetric with pelvic corrective force at 9% of body weight.

CONCLUSIONS

Applying a mediolateral pelvic corrective force toward the paretic side may enhance muscle activity of the paretic leg and improve pelvis displacement symmetry in individuals post-stroke.

SIGNIFICANCE

Forceful weight shift to the paretic side could potentially force additional use of the paretic leg and improve the walking pattern.

摘要

目的

确定在跑步机行走过程中向骨盆施加内外侧矫正力是否会增强中风后偏瘫患者患侧下肢的肌肉活动并改善步态对称性。

方法

15名中风后偏瘫患者参与了本研究。一个基于跑步机的定制缆线驱动机器人系统在站立初期向骨盆朝患侧施加内外侧矫正力。施加了三种不同大小的矫正力。收集患侧下肢的肌电图(EMG)活动、时空步态参数和骨盆横向位移。

结果

当施加骨盆矫正力时,观察到髋外展肌、半腱肌、比目鱼肌、股直肌、股内侧肌和胫前肌的积分肌电图显著增加,与体重的3%或6%相比,体重9%的骨盆矫正力诱发的肌肉活动更大。体重9%的骨盆矫正力使骨盆横向位移更对称。

结论

向患侧施加内外侧骨盆矫正力可能会增强中风后患者患侧下肢的肌肉活动并改善骨盆位移对称性。

意义

向患侧有力地转移体重可能会促使更多地使用患侧下肢并改善行走模式。

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