Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Graduate School of Biomedical Engineering, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
J Biomech. 2019 Mar 27;86:204-209. doi: 10.1016/j.jbiomech.2019.02.012. Epub 2019 Feb 20.
Regulation of whole-body angular momentum (WBAM) is essential for maintaining dynamic balance during gait. Patients with hemiparesis frequently fall toward the anterior direction; however, whether this is due to impaired WBAM control in the sagittal plane during gait remains unknown. The present study aimed to investigate the differences in WBAM in the sagittal plane during gait between patients with hemiparesis and healthy individuals. Thirty-three chronic stroke patients with hemiparesis and twenty-two age- and gender-matched healthy controls walked along a 7-m walkway while gait data were recorded using a motion analysis system and force plates. WBAM and joint moment were calculated in the sagittal plane during each gait cycle. The range of WBAM in the sagittal plane in the second half of the paretic gait cycle was significantly larger than that in the first and second halves of the right gait cycle in the controls (P = 0.015 and P = 0.011). Furthermore, multiple regression analysis revealed the slower walking speed (P < 0.001) and larger knee extension moment on the non-paretic side (P = 0.003) contributed to the larger range of WBAM in the sagittal plane in the second half of the paretic gait cycle. Our findings suggest that dynamic stability in the sagittal plane is impaired in the second half of the paretic gait cycle. In addition, the large knee extension moment on the non-paretic side might play a role in the dynamic instability in the sagittal plane during gait in patients with hemiparesis.
全身角动量（WBAM）的调节对于维持步态中的动态平衡至关重要。偏瘫患者经常向前摔倒；然而，这是否是由于步态中矢状面 WBAM 控制受损仍不清楚。本研究旨在探讨偏瘫患者和健康对照者在矢状面步态中 WBAM 的差异。33 名慢性脑卒中偏瘫患者和 22 名年龄和性别匹配的健康对照者在 7 米长的步行道上行走，同时使用运动分析系统和测力板记录步态数据。在每个步态周期中计算矢状面 WBAM 和关节力矩。患侧步态周期后半部分的矢状面 WBAM 范围明显大于对照组右侧步态周期前半部分和后半部分（P=0.015 和 P=0.011）。此外，多元回归分析显示，较慢的步行速度（P<0.001）和非患侧膝关节伸展力矩较大（P=0.003）导致患侧步态周期后半部分矢状面 WBAM 范围较大。我们的发现表明，患侧步态周期后半部分矢状面动态稳定性受损。此外，非患侧膝关节伸展力矩较大可能在偏瘫患者步态中矢状面动态不稳定中起作用。
