Pereira Juliana Aparecida, de Souza Karine Külkamp, Pereira Suzana Matheus, Ruschel Caroline, Hubert Marcel, Michaelsen Stella Maris
University of the State of Santa Catarina, Graduate Program in Physical Therapy, Centre of Health and Sports Sciences, Rua Pascoal Simone, 358, 88080-350 Florianópolis, SC, Brazil.
University of the State of Santa Catarina, Graduate Program in Physical Therapy, Centre of Health and Sports Sciences, Rua Pascoal Simone, 358, 88080-350 Florianópolis, SC, Brazil; University of the State of Santa Catarina, Graduate Program in Movement Science, Centre of Health and Sports Sciences, Rua Pascoal Simone, 358, 88080-350 Florianópolis, SC, Brazil.
Clin Biomech (Bristol). 2019 Dec;70:16-22. doi: 10.1016/j.clinbiomech.2019.07.024. Epub 2019 Jul 23.
Devices are commonly used in aquatic gait rehabilitation; therefore, investigating the effect of these devices is important. We evaluated the combined use of buoyancy cuffs and ankle weights during aquatic gait on paretic leg kinematics in people with hemiparesis.
Fifteen adults (58.6 ± 4.8 years) in the chronic phase post-stroke walked on a 4.5 m walkway with underwater immersion at the height of the xiphoid process in five conditions: (1) without equipment; (2) with ankle weights or (3) buoyancy cuffs on both legs; (4) with a buoyancy leg cuff on the non-paretic leg and an ankle weight on the paretic leg; (5) with an ankle weight on the non-paretic leg and a buoyancy leg cuff on the paretic leg. Five trials were performed for each condition for a total of 25 trials and the kinematic data were recorded. Analysis of covariance was used with walking velocity as a covariate to analyze spatiotemporal and angular variables of the paretic leg.
The condition with buoyancy cuff on the paretic leg increased (~20°) the maximum angle of knee flexion in the mid-swing phase compared to that seen with weights on both legs or weight on the paretic leg. Buoyancy cuffs on the paretic leg increased the step length by 5.6 cm. The ankle weights on the paretic leg condition increased the total (6%) and single support (4%) duration compared to that seen with a buoyancy cuff on the paretic leg.
Aquatic gait with buoyancy cuffs on both legs or on the paretic leg can modify gait kinematics compared to that with weight on both legs or on the paretic leg. Long term effects of training with those conditions needs further research.
设备常用于水上步态康复；因此，研究这些设备的效果很重要。我们评估了在水上步态训练中，浮力袖带和踝部负重联合使用对偏瘫患者患侧腿运动学的影响。
15名处于中风后慢性期的成年人（58.6±4.8岁）在一条4.5米长的通道上行走，水下浸没深度为剑突高度，共进行五种情况的测试：（1）不使用设备；（2）双腿佩戴踝部负重；（3）双腿佩戴浮力袖带；（4）非患侧腿佩戴浮力腿袖带，患侧腿佩戴踝部负重；（5）非患侧腿佩戴踝部负重，患侧腿佩戴浮力腿袖带。每种情况进行5次试验，共25次试验，并记录运动学数据。采用协方差分析，将步行速度作为协变量，分析患侧腿的时空和角度变量。
与双腿佩戴负重或患侧腿佩戴负重相比，患侧腿佩戴浮力袖带的情况在摆动中期使膝关节最大屈曲角度增加了约20°。患侧腿佩戴浮力袖带使步长增加了5.6厘米。与患侧腿佩戴浮力袖带相比，患侧腿佩戴踝部负重的情况使总支撑期（6%）和单支撑期（4%）延长。
与双腿或患侧腿佩戴负重相比，双腿或患侧腿佩戴浮力袖带的水上步态可改变步态运动学。这些训练条件的长期效果需要进一步研究。
