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步行中脑卒中患者的耗氧量:偏瘫与小脑性共济失调。

Oxygen Cost During Walking in Individuals With Stroke: Hemiparesis Versus Cerebellar Ataxia.

机构信息

University of Limoges, Limoges, France.

University Hospital Center of Limoges, Limoges, France.

出版信息

Neurorehabil Neural Repair. 2020 Apr;34(4):289-298. doi: 10.1177/1545968320907076. Epub 2020 Feb 24.

DOI:10.1177/1545968320907076
PMID:32089099
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7168805/
Abstract

. Understanding the factors that limit mobility in stroke patients is fundamental for proposing appropriate rehabilitation strategies. A high oxygen cost during walking (Cw) has a strong impact on the community ambulation of hemiparetic patients. The Cw in poststroke cerebellar ataxia is poorly evaluated, unlike hemiparetic gait. . To compare the oxygen cost/self-selected walking speed (S) relationship in stroke individuals with cerebellar ataxia or hemiparetic gait. . Thirty-three subjects were included (14 cerebellar stroke, 19 hemispheric stroke), with stroke confirmed by brain imaging and able to walk without human assistance. We measured Cw using the Metamax3B. The relationship between Cw and self-selected walking speed was modelled by logistic regression and then compared between the cerebellar and hemispheric groups. . No significant difference was found between the 2 groups for all characteristics of the population, except motor impairments, spasticity, and ataxia ( < .01). We identified 2 separate Cw/S relationships with different logistic regression equations for the 2 groups. Faster than 0.4 m s, Cw was 30.6% to 39.9% higher in patients with cerebellar stroke in comparison with hemispheric stroke individuals. The Cw was correlated with ataxia ( = 0.88; < .001) in the cerebellar group, whereas there was a correlation with motor impairments ( = -0.61; < .01), spasticity ( = 0.59; < .01), and ataxia ( = 0.81; < .01) in hemispheric stroke individuals. . The Cw in poststroke cerebellar ataxia is significantly higher compared with hemiparetic patients at an equivalent walking speed. The impact on community walking needs to be explored in stroke survivors with cerebellar stroke.

摘要

. 了解限制脑卒中患者活动能力的因素对于提出适当的康复策略至关重要。步行时的高耗氧量(Cw)对偏瘫患者的社区步行能力有很大影响。与偏瘫步态不同,脑卒中后小脑性共济失调的 Cw 评估较差。. 比较小脑性共济失调或偏瘫步态脑卒中患者的耗氧量/自定步行速度(S)关系。. 纳入 33 名受试者(14 例小脑卒,19 例半球卒),通过脑成像证实卒中,且能够无需他人帮助行走。使用 Metamax3B 测量 Cw。使用逻辑回归对 Cw 与自定步行速度的关系进行建模,然后比较小脑组和半球组之间的关系。. 2 组间除运动障碍、痉挛和共济失调外( <.01),所有人群特征均无显著差异。我们确定了 2 个独立的 Cw/S 关系,对于 2 个组,逻辑回归方程不同。在小脑卒中患者中,步行速度快于 0.4m/s 时,Cw 比半球卒中患者高 30.6%至 39.9%。在小脑组中,Cw 与共济失调( = 0.88; <.001)相关,而在半球卒中患者中,Cw 与运动障碍( = -0.61; <.01)、痉挛( = 0.59; <.01)和共济失调( = 0.81; <.01)相关。. 与偏瘫患者相比,脑卒中后小脑性共济失调患者在相同步行速度下的 Cw 明显更高。需要在小脑卒中幸存者中探讨对社区行走的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/40ebb3bcfaa8/10.1177_1545968320907076-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/78283789c547/10.1177_1545968320907076-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/c15bfa79e287/10.1177_1545968320907076-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/40ebb3bcfaa8/10.1177_1545968320907076-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/78283789c547/10.1177_1545968320907076-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/c15bfa79e287/10.1177_1545968320907076-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8e/7168805/40ebb3bcfaa8/10.1177_1545968320907076-fig3.jpg

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本文引用的文献

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Predicting the oxygen cost of walking in hemiparetic stroke patients.预测偏瘫中风患者行走的耗氧量。
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A systematic review of the gait characteristics associated with Cerebellar Ataxia.
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bioRxiv. 2024 Jun 2:2024.05.28.596299. doi: 10.1101/2024.05.28.596299.
一项关于与小脑共济失调相关的步态特征的系统综述。
Gait Posture. 2018 Feb;60:154-163. doi: 10.1016/j.gaitpost.2017.11.024. Epub 2017 Dec 1.
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Relationship between oxygen cost of walking and level of walking disability after stroke: An experimental study.中风后步行的氧耗与步行残疾程度之间的关系:一项实验研究。
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