Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA.
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA.
Clin Biomech (Bristol). 2020 Mar;73:172-180. doi: 10.1016/j.clinbiomech.2020.01.005. Epub 2020 Jan 28.
Individuals post-stroke have an increased risk of falling, which can lead to injuries and reduced quality of life. This increased fall risk can be partially attributed to poorer balance control, which has been linked to altered post-stroke gait kinematics (e.g. an increased step width). The application of lateral stabilization to the pelvis reduces step width among neurologically-intact young and older adults, suggesting that lateral stabilization reduces the need for active frontal plane balance control. This study sought to determine if lateral stabilization is effective at improving common measures of gait performance and dynamic balance in neurologically-intact and post-stoke individuals who responded to the stabilization by reducing their step width.
Gait performance was assessed by foot placement and propulsion symmetry while dynamic balance was assessed by peak-to-peak range of frontal plane whole body angular momentum (H) and pelvis and trunk sway.
Controls and post-stroke Responders who reduced their step width in response to stabilization also reduced their mediolateral pelvis sway, but did not exhibit changes in gait performance. Contrary to expectations, both groups exhibited an increased H, possibly indicative of decreased balance control. This increase was the result of increased relative velocity between the pelvis and head, arms and trunk segment.
These results suggest that a reduction in pelvis motion alone, as opposed to relative motion between the pelvis and upper body, may increase H, decrease balance control and diminish gait performance. This finding has important implications for locomotor therapies that may seek to reduce pelvis motion.
中风后个体的跌倒风险增加，这可能导致受伤和生活质量下降。这种增加的跌倒风险部分归因于平衡控制能力下降，这与中风后步态运动学的改变有关（例如，步宽增加）。骨盆的侧向稳定可以减少神经健全的年轻和老年成年人的步宽，这表明侧向稳定减少了对主动额状面平衡控制的需求。本研究旨在确定侧向稳定是否能有效改善神经健全和中风后个体的常见步态表现和动态平衡指标，这些个体通过减少步宽来对稳定化做出反应。
通过脚部放置和推进对称性评估步态表现，通过额状面全身角动量（H）的峰值到峰值范围和骨盆和躯干摆动评估动态平衡。
对稳定化做出反应并减少步宽的对照组和中风后反应者的骨盆侧向摆动也减少了，但步态表现没有变化。与预期相反，两组的 H 都增加了，这可能表明平衡控制能力下降。这种增加是骨盆和头部、手臂和躯干段之间相对速度增加的结果。
这些结果表明，骨盆运动的减少，而不是骨盆和上半身之间的相对运动，可能会增加 H，降低平衡控制能力，并降低步态表现。这一发现对可能试图减少骨盆运动的运动疗法具有重要意义。
