Mao Yu Rong, Wu Xiu Qin, Zhao Jiang Li, Lo Wai Leung Ambrose, Chen Ling, Ding Ming Hui, Xu Zhi Qin, Bian Rui Hao, Huang Dong Feng, Li Le
Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Neurol. 2018 Mar 26;9:185. doi: 10.3389/fneur.2018.00185. eCollection 2018.
The aim of this study was to detect the key changes during sit-to-stand (STS) movement cycle in hemiparetic stroke survivors using a five-phase kinematic and kinetic analysis.
Twenty-five subacute stroke survivors and 17 age-matched healthy adults participated in this study. The kinematic and kinetic parameters during STS cycle were measured using three-dimensional motion analysis system with force plates. The five standard phases of STS cycle were identified by six timing transitional points.
Longer total time as well as larger changes were observed at the initial phase (phase I, 0.76 ± 0.62 VS 0.43 ± 0.09 s; = 0.049) and at the end of hip and knee extension phase (phase IV, 0.93 ± 0.41 VS 0.63 ± 0.14 s; = 0.008) in the stroke group than healthy group. Time to maximal knee joint moment was significantly delayed in the stroke group than in the control group (1.14 ± 1.06 VS 0.60 ± 0.09 s, < 0.001). The maximal hip flexion was lower during the rising phase from seated position on the affected side in the stroke group than in the control group (84.22° ± 11.64°VS 94.11° ± 9.40°; = 0.022). Ground reaction force was lower (4.61 ± 0.73 VS 5.85 ± 0.53 N, < 0.001) in the affected side of the stroke group than in the control group. In addition, knee joint flexion was significantly lower at just-standing phase (T) and at end point (T) (5.12° ± 5.25° VS 8.21° ± 7.28°, = 0.039; 0.03° ± 5.41° VS 3.07° ± 6.71°, = 0.042) on the affected side than the unaffected side. Crucial decrease of knee joint moment at abrupt transitory (T) and the maximal moment was also observed on the affected side in comparison with the unaffected side (0.39 ± 0.29 VS 0.77 ± 0.25 Nm/kg, < 0.001; 0.42 ± 0.38 VS 0.82 ± 0.24 Nm/kg, < 0.001).
The findings of movement decomposition analysis provided useful information to clinical evaluation of STS performance, and may potentially contribute to the design of rehabilitation intervention program for optimum functional recovery of STS after stroke.
本研究旨在通过五阶段运动学和动力学分析，检测偏瘫性脑卒中幸存者从坐到站（STS）运动周期中的关键变化。
25名亚急性脑卒中幸存者和17名年龄匹配的健康成年人参与了本研究。使用带有测力板的三维运动分析系统测量STS周期中的运动学和动力学参数。通过六个时间转换点确定STS周期的五个标准阶段。
与健康组相比，脑卒中组在初始阶段（阶段I，0.76±0.62秒对0.43±0.09秒；P = 0.049）以及髋关节和膝关节伸展阶段结束时（阶段IV，0.93±0.41秒对0.63±0.14秒；P = 0.008）观察到总时间更长以及变化更大。脑卒中组达到最大膝关节力矩的时间比对照组显著延迟（1.14±1.06秒对0.60±0.09秒，P < 0.001）。脑卒中组患侧从坐位起身阶段的最大髋关节屈曲角度低于对照组（84.22°±11.64°对94.11°±9.40°；P = 0.022）。脑卒中组患侧的地面反作用力低于对照组（4.61±0.73牛对5.85±0.53牛，P < 0.001）。此外，患侧在刚站立阶段（T）和终点（T）时膝关节屈曲角度显著低于健侧（5.12°±5.25°对8.21°±7.28°，P = 0.039；0.03°±5.41°对3.07°±6.71°，P = 0.042）。与健侧相比，患侧在突然过渡（T）时膝关节力矩的关键下降以及最大力矩也被观察到（0.39±0.29牛米/千克对0.77±0.25牛米/千克，P < 0.001；0.42±0.38牛米/千克对0.82±0.24牛米/千克，P < 0.001）。
运动分解分析的结果为STS表现的临床评估提供了有用信息，并可能有助于设计康复干预方案，以促进脑卒中后STS功能的最佳恢复。
