Mechanical Engineering, University of Delaware, Newark, DE, USA.
Physical Therapy, University of Delaware, Newark, DE, USA.
J Biomech. 2020 Mar 5;101:109643. doi: 10.1016/j.jbiomech.2020.109643. Epub 2020 Jan 16.
The objective of this study was to determine how individuals poststroke respond to user-driven treadmill (UDTM) controlin terms ofwalking speeds, peak anterior ground reaction forces (AGRF), peak posterior ground reaction forces (PGRF), and trailing limb angles (TLA). Twenty individuals with chronic stroke walked overground during a 10-meter walk test to determine their self-selected (SS) speeds before walking on a treadmill in its fixed-speed (FSTM) and UDTM control modes at their SS and fastest comfortable (Fast) speeds. Paired t-tests were used to compare the walking speeds, peak AGRF, peak PGRF, and TLA among test conditions (α = 0.05). Participants selected similar SS (p > 0.05) and faster Fast walking speeds (p < 0.05) with the UDTM control compared to the FSTM control. There were no changes in their peak AGRF or PGRF for either limb or speed between UDTM and FSTM conditions (p > 0.05). Individuals used greater paretic TLA at SS speeds with UDTM control (p < 0.05). There was no difference in the AGRF required at Fast speeds with FSTM and UDTM control even though participants selected faster speeds with UDTM control. In work with young, healthy adults, we found that the treadmill control condition did not affect the amount of forward propulsion needed. Therefore, it is likely that when walking with UDTM control, individuals poststroke adjust their posture to make better use of their forward propulsion. This means they can reach faster walking speeds without increasing their push-off forces. Future work should assess how to most effectively prescribe UDTM control for gait training programs.
本研究旨在确定脑卒中患者在使用用户驱动跑步机（UDTM）控制时，其行走速度、峰值前向地面反作用力（AGRF）、峰值后向地面反作用力（PGRF）和拖曳肢体角度（TLA）的反应。20 名慢性脑卒中患者在进行 10 米步行测试以确定其自我选择（SS）速度后，在跑步机的固定速度（FSTM）和 UDTM 控制模式下以 SS 和最快舒适（Fast）速度行走，在这些测试条件下，采用配对 t 检验比较行走速度、峰值 AGRF、峰值 PGRF 和 TLA（α=0.05）。与 FSTM 控制相比，UDTM 控制下，患者选择了相似的 SS（p>0.05）和更快的 Fast 行走速度（p<0.05）。在 UDTM 和 FSTM 条件下，双侧的峰值 AGRF 或 PGRF 或速度均无变化（p>0.05）。与 FSTM 控制相比，患者在使用 UDTM 控制时，在 SS 速度下使用更大的患侧 TLA（p<0.05）。尽管患者在 UDTM 控制下选择了更快的速度，但在 Fast 速度下，FSTM 和 UDTM 控制所需的 AGRF 并无差异。在与年轻健康成年人的合作中，我们发现跑步机控制条件不会影响所需的向前推进力。因此，当使用 UDTM 控制行走时，脑卒中患者可能会调整其姿势，以更好地利用向前推进力。这意味着他们可以达到更快的行走速度，而无需增加其蹬离力量。未来的工作应该评估如何最有效地为步态训练计划规定 UDTM 控制。
