Roessingh Research and Development, Enschede, The Netherlands.
Department of Biomechanical Engineering, University of Twente, Horstring W119, PO Box 217, 7500 AE, Enschede, The Netherlands.
J Neuroeng Rehabil. 2017 Oct 13;14(1):106. doi: 10.1186/s12984-017-0317-z.
The effects of a stroke, such as hemiparesis, can severely hamper the ability to walk and to maintain balance during gait. Providing support to stroke survivors through a robotic exoskeleton, either to provide training or daily-life support, requires an understanding of the balance impairments that result from a stroke. Here, we investigate the differences between the paretic and non-paretic leg in making recovery steps to restore balance following a disturbance during walking.
We perturbed 10 chronic-stage stroke survivors during walking using mediolateral perturbations of various amplitudes. Kinematic data as well as gluteus medius muscle activity levels during the first recovery step were recorded and analyzed.
The results show that this group of subjects is able to modulate foot placement in response to the perturbations regardless of the leg being paretic or not. Modulation in gluteus medius activity with the various perturbations is in line with this observation. In general, the foot of the paretic leg was laterally placed further away from the center of mass than that of the non-paretic leg, while subjects spent more time standing on the non-paretic leg.
The findings suggest that, though stroke-related gait characteristics are present, the modulation with the various perturbations remains unaffected. This might be because all subjects were only mildly impaired, or because these stepping responses partly occur through involuntary pathways which remain unaffected by the complications after the stroke.
中风的影响，如偏瘫，会严重影响行走和步态平衡的能力。通过机器人外骨骼为中风幸存者提供支持，无论是提供训练还是日常生活支持，都需要了解中风导致的平衡障碍。在这里，我们研究了在行走过程中受到干扰后，为恢复平衡而进行恢复步时，偏瘫侧和非偏瘫侧腿之间的差异。
我们通过各种幅度的横向扰动，在行走过程中对 10 名慢性期中风幸存者进行了扰动。记录和分析了运动学数据以及第一恢复步时臀中肌的活动水平。
结果表明，无论腿是否偏瘫，该组受试者都能够根据扰动来调节脚步位置。各种扰动下臀中肌活动的调节与这一观察结果一致。一般来说，偏瘫腿的脚比非偏瘫腿更偏向身体中线的外侧，而受试者在非偏瘫腿上站立的时间更长。
研究结果表明，尽管存在与中风相关的步态特征，但各种扰动的调节不受影响。这可能是因为所有受试者的损伤都很轻微，或者是因为这些跨步反应部分通过不受中风后并发症影响的无意识途径发生。
