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不同步行速度的中风后偏瘫患者的步态特征

Gait characteristics of post-stroke hemiparetic patients with different walking speeds.

作者信息

Wang Yiji, Mukaino Masahiko, Ohtsuka Kei, Otaka Yohei, Tanikawa Hiroki, Matsuda Fumihiro, Tsuchiyama Kazuhiro, Yamada Junya, Saitoh Eiichi

机构信息

Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.

Department of Spinal Cord Injury Rehabilitation, China Rehabilitation Research Center.

出版信息

Int J Rehabil Res. 2020 Mar;43(1):69-75. doi: 10.1097/MRR.0000000000000391.

Abstract

Hemiparesis resulting from stroke presents characteristic spatiotemporal gait patterns. This study aimed to clarify the spatiotemporal gait characteristics of hemiparetic patients by comparing them with height-, speed-, and age-matched controls while walking at various speeds. The data on spatiotemporal gait parameters of stroke patients and that of matched controls were extracted from a hospital gait analysis database. In total, 130 pairs of data were selected for analysis. Patients and controls were compared for spatiotemporal gait parameters and the raw value (RSI) and absolute value (ASI) of symmetry index and coefficient of variation (CV) of these parameters. Stroke patients presented with prolonged nonparetic stance (patients vs. controls: 1.01 ± 0.41 vs. 0.83 ± 0.25) and paretic swing time (0.45 ± 0.12 vs. 0.39 ± 0.07), shortened nonparetic swing phase (0.35 ± 0.07 vs. 0.39 ± 0.07), and prolonged paretic and nonparetic double stance phases [0.27 ± 0.13 (paretic)/0.27 ± 0.17 (nonparetic) vs. 0.22 ± 0.10]. These changes are especially seen in low-gait speed groups (<3.4 km/h). High RSIs of stance and swing times were also observed (-9.62 ± 10.32 vs. -0.79 ± 2.93, 24.24 ± 25.75 vs. 1.76 ± 6.43, respectively). High ASIs and CVs were more generally observed, including the groups with gait speed of ≥3.5 km/h. ASI increase of the swing phase (25.79 ± 22.69 vs. 4.83 ± 4.88) and CV of the step length [7.7 ± 4.9 (paretic)/7.6 ± 5.0 (nonparetic) vs. 5.3 ± 3.0] were observed in all gait speed groups. Our data suggest that abnormalities in the spatiotemporal parameters of hemiparetic gait should be interpreted in relation to gait speed. ASIs and CVs could be highly sensitive indices for detecting gait abnormalities.

摘要

中风导致的偏瘫呈现出独特的时空步态模式。本研究旨在通过将偏瘫患者与身高、速度和年龄匹配的对照组在不同速度行走时进行比较,以阐明偏瘫患者的时空步态特征。中风患者和匹配对照组的时空步态参数数据从医院步态分析数据库中提取。总共选择了130对数据进行分析。比较患者和对照组的时空步态参数以及这些参数的对称指数的原始值(RSI)和绝对值(ASI)和变异系数(CV)。中风患者表现为健侧支撑期延长(患者与对照组:1.01±0.41对0.83±0.25)和患侧摆动时间延长(0.45±0.12对0.39±0.07),健侧摆动相缩短(0.35±0.07对0.39±0.07),以及患侧和健侧双支撑期延长[0.27±0.13(患侧)/0.27±0.17(健侧)对0.22±0.10]。这些变化在低步态速度组(<3.4 km/h)中尤为明显。还观察到支撑期和摆动期的高RSI(分别为-9.62±10.32对-0.79±2.93,24.24±25.75对1.76±6.43)。更普遍地观察到高ASI和CV,包括步态速度≥3.5 km/h的组。在所有步态速度组中均观察到摆动期的ASI增加(25.79±22.69对4.83±4.88)和步长的CV[7.7±4.9(患侧)/7.6±5.0(健侧)对5.3±3.0]。我们的数据表明,偏瘫步态的时空参数异常应结合步态速度来解释。ASI和CV可能是检测步态异常的高度敏感指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/171c/7028468/040e4d1d3e80/ijrr-43-69-g001.jpg

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