Kempski Kelley, Awad Louis N, Buchanan Thomas S, Higginson Jill S, Knarr Brian A
Department of Biomedical Engineering, University of Delaware, Newark, DE, United States.
Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, United States; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States.
J Biomech. 2018 Feb 8;68:1-5. doi: 10.1016/j.jbiomech.2017.12.019. Epub 2017 Dec 15.
Variability in joint kinematics is necessary for adaptability and response to everyday perturbations; however, intrinsic neuromotor changes secondary to stroke often cause abnormal movement patterns. How these abnormal movement patterns relate to joint kinematic variability and its influence on post-stroke walking impairments is not well understood.
The purpose of this study was to evaluate the movement variability at the individual joint level in the paretic and non-paretic limbs of individuals post-stroke.
Seven individuals with hemiparesis post-stroke walked on a treadmill for two minutes at their self-selected speed and the average speed of the six-minute walk test while kinematics were recorded using motion-capture. Variability in hip, knee, and ankle flexion/extension angles during walking were quantified with the Lyapunov exponent (LyE). Interlimb differences were evaluated.
The paretic side LyE was higher than the non-paretic side at both self-selected speed (Hip: 50%; Knee: 74%), and the average speed of the 6-min walk test (Hip: 15%; Knee: 93%).
Differences in joint kinematic variability between limbs of persons post-stroke supports further study of the source of non-paretic limb deviations as well as the clinical implications of joint kinematic variability in persons post-stroke. The development of bilaterally-targeted post-stroke gait interventions to address variability in both limbs may promote improved outcomes.
关节运动学的变异性对于适应和应对日常扰动是必要的；然而，中风继发的内在神经运动变化常导致异常运动模式。这些异常运动模式如何与关节运动学变异性相关以及其对中风后步行障碍的影响尚不清楚。
本研究的目的是评估中风后个体患侧和健侧肢体单个关节水平的运动变异性。
7名中风后偏瘫患者在跑步机上以自我选择的速度以及6分钟步行试验的平均速度行走两分钟，同时使用动作捕捉记录运动学数据。步行过程中髋、膝和踝关节屈伸角度的变异性用李雅普诺夫指数（LyE）进行量化。评估双侧差异。
在自我选择速度（髋部：50%；膝部：74%）和6分钟步行试验的平均速度（髋部：15%；膝部：93%）下，患侧的LyE均高于健侧。
中风后个体双侧肢体关节运动学变异性的差异支持进一步研究健侧肢体偏差的来源以及关节运动学变异性对中风后个体的临床意义。开发针对双侧的中风后步态干预措施以解决双侧肢体的变异性可能会促进更好的结果。
