School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan.
Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto, Japan.
NeuroRehabilitation. 2019 Dec 18;45(4):493-499. doi: 10.3233/NRE-192923.
Disturbed lower limb coordination is thought to limit gait ability in patients with stroke. However, the relationship of lower limb coordination with gait kinematics and physical function has not yet been clarified.
The purpose of the study was to clarify the gait kinematic and physical function variables that most affect intralimb coordination by using the continuous relative phase (CRP) between the thigh and shank.
Fifteen participants with stroke were enrolled in this study. Kinematic and kinetic measurements were recorded during gait at preferred speeds. CRP was defined as the difference between the thigh and shank phase angles.
Stepwise analysis revealed that non-paretic CRP during the propulsive phase was a determinant of gait speed. The paretic knee extension and flexion angles were determinants of the CRP during the propulsive phase in the non-paretic limb. Stepwise analysis showed that the paretic knee extension angle was a determinant of the CRP during the propulsive phase in the paretic limb. Stepwise analysis revealed that the paretic knee extensor muscle strength was a determinant of the CRP during the propulsive phase in both limbs.
Our study indicates that improvement in knee movement during the stance phase may improve coordination.
下肢协调障碍被认为会限制脑卒中患者的步态能力。然而，下肢协调与步态运动学和身体功能之间的关系尚未阐明。
本研究旨在通过股胫连续相对相位（CRP）明确最能影响肢体内协调的步态运动学和身体功能变量。
本研究纳入了 15 名脑卒中患者。在惯用速度下行走时记录运动学和动力学测量值。CRP 定义为大腿和小腿相位角的差值。
逐步分析显示，推进相非瘫痪侧 CRP 是步行速度的决定因素。瘫痪侧膝关节伸屈角度是非瘫痪侧推进相 CRP 的决定因素。逐步分析显示，瘫痪侧膝关节伸肌角度是瘫痪侧推进相 CRP 的决定因素。逐步分析表明，双侧膝关节伸肌肌力是推进相 CRP 的决定因素。
我们的研究表明，改善站立阶段膝关节运动可能会改善协调能力。
