Chen Na, Xiao Xiang, Hu Huijing, Chen Ying, Song Rong, Li Le
Department of Rehabilitation Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Rehabilitation Medicine, Luo Hu Peoples' Hospital, Shenzhen, China.
Front Neurol. 2019 Jul 30;10:813. doi: 10.3389/fneur.2019.00813. eCollection 2019.
This study aims to compare the differences in the kinematic characteristics of crossing obstacles of different heights between stroke survivors and age-matched healthy controls and to identify the changes of balance control strategy and risk of falling. Twelve stroke survivors and twelve aged-matched healthy controls were recruited. A three-dimensional motion analysis system and two force plates were used to measure the kinematic and kinetic data during crossing obstacles with heights of 10, 20, and 30% leg length. The results showed that during leading and trailing limb clearance, (AP) center of mass (COM) velocities of the stroke group were smaller than those of the healthy controls for all heights. The decreased distances between COM and center of pressure (COP) in the AP direction during the both trailing and leading limb support period were also found between stroke survivors and healthy controls for all heights. The COM velocity and COM-COP distance significantly correlated with the lower limb muscle strength. In addition, stroke survivors showed greater lateral pelvic tilt, greater hip abduction, and larger peak velocity in the medio-lateral (ML) direction. There was a positive correlation between the COM-COP distance in the AP direction and the clinical scales. These results might identify that the stroke survivors used a conservative strategy to negotiate the obstacles and control balance due to a lack of muscle strength. However, the abnormal patterns during obstacle crossing might increase the risk of falling. The findings could be used to design specific rehabilitation training programs to enhance body stability, reduce energy cost, and improve motion efficiency.
本研究旨在比较中风幸存者与年龄匹配的健康对照者跨越不同高度障碍物时的运动学特征差异，并确定平衡控制策略的变化和跌倒风险。招募了12名中风幸存者和12名年龄匹配的健康对照者。使用三维运动分析系统和两个测力台来测量在跨越高度为腿长的10%、20%和30%的障碍物过程中的运动学和动力学数据。结果表明，在摆动腿和支撑腿离地期间，中风组在所有高度下的前后向（AP）质心（COM）速度均小于健康对照组。在所有高度下，中风幸存者与健康对照者在支撑腿摆动期和支撑腿支撑期的前后向AP方向上，COM与压力中心（COP）之间的距离减小也有差异。COM速度和COM-COP距离与下肢肌肉力量显著相关。此外，中风幸存者表现出更大的骨盆侧倾、更大的髋关节外展以及在内外侧（ML）方向上更大的峰值速度。AP方向上的COM-COP距离与临床量表之间存在正相关。这些结果可能表明，由于缺乏肌肉力量，中风幸存者采用保守策略来越过障碍物并控制平衡。然而，跨越障碍物时的异常模式可能会增加跌倒风险。这些发现可用于设计特定的康复训练计划，以增强身体稳定性、降低能量消耗并提高运动效率。
