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下肢和躯干肌肉力量与亚急性脑卒中患者的步速相关:一项横断面研究。

Strength of the lower limb and trunk muscles is associated with gait speed in individuals with sub-acute stroke: a cross-sectional study.

机构信息

Universidade Federal de Minas Gerais (UFMG), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil.

Universidade Federal de Minas Gerais (UFMG), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil.

出版信息

Braz J Phys Ther. 2018 Nov-Dec;22(6):459-466. doi: 10.1016/j.bjpt.2018.03.001. Epub 2018 Mar 15.

Abstract

OBJECTIVES

To investigate the association between measures of strength of the lower limb and trunk muscles and gait speed and to identify the muscle group that would best predict gait speed in individuals with sub-acute stroke.

METHODS

Using a cross-sectional observational study design, forty-four individuals with sub-acute stroke (62 years, SD=14; 4 months, SD=1 post-stroke) were assessed. The evaluations were performed at a university laboratory, participants' homes, or community-based settings. Bilateral maximum isometric strength (hip, knee, and ankle flexors/extensors, hip abductors, trunk flexors/extensors, and trunk lateral flexors and rotators) was measured using a portable dynamometer. Comfortable and maximum gait speeds were measured using the 10-m walk test.

RESULTS

Weak to moderate associations were found between measures of strength of the lower limb muscles and comfortable (0.36≤r≤0.53; p<0.05) and maximum (0.37≤r≤0.59; p<0.05) gait speeds, except for the non-paretic knee flexors and comfortable gait speed (p=0.06). Weak to moderate associations were also found between measures of strength of the trunk muscles and comfortable (0.39≤r≤0.50; p<0.05) and maximum (0.39≤r≤0.61; p<0.05) gait speeds. Stepwise multiple regression analyses revealed that the non-paretic dorsiflexors and the left lateral trunk flexors explained 29% and 42% of the variance in the maximum and comfortable gait speeds, respectively.

CONCLUSIONS

The strength of the lower limb and trunk muscles was positively associated with comfortable and maximum gait speeds. The muscle strength of the non-paretic dorsiflexors and the left lateral trunk flexors might have a role to play in determining comfortable and maximum gait speeds of individuals with sub-acute stroke.

摘要

目的

研究下肢和躯干肌肉力量的测量值与步速之间的关系,并确定亚急性脑卒中患者中预测步速的最佳肌肉群。

方法

采用横断面观察性研究设计,对 44 名亚急性脑卒中患者(62 岁,标准差=14;发病后 4 个月,标准差=1)进行评估。评估在大学实验室、患者家中或社区环境中进行。使用便携式测力计测量双侧最大等长力量(髋关节、膝关节和踝关节屈伸肌/伸展肌、髋关节外展肌、躯干屈伸肌和躯干侧屈肌和旋转肌)。使用 10 米步行测试测量舒适和最大步行速度。

结果

下肢肌肉力量的测量值与舒适(0.36≤r≤0.53;p<0.05)和最大(0.37≤r≤0.59;p<0.05)步速之间存在弱到中度关联,除了非瘫痪侧膝关节屈肌与舒适步行速度(p=0.06)外。躯干肌肉力量的测量值与舒适(0.39≤r≤0.50;p<0.05)和最大(0.39≤r≤0.61;p<0.05)步速之间也存在弱到中度关联。逐步多元回归分析显示,非瘫痪侧背屈肌和左侧侧躯干屈伸肌分别解释了最大和舒适步行速度的 29%和 42%的方差。

结论

下肢和躯干肌肉力量与舒适和最大步速呈正相关。非瘫痪侧背屈肌和左侧侧躯干屈伸肌的肌肉力量可能在确定亚急性脑卒中患者的舒适和最大步速方面发挥作用。

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