Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland.
Department of Neurological Rehabilitation, Provincial Specialist Hospital, Research and Development Centre, Wrocław, Poland.
Acta Bioeng Biomech. 2020;22(1):11-20.
Stroke-related hemiplegia is an important factor influencing parameters of gait. So far, limited papers have assessed temporo- spatial capabilities and their correlations with gait parameters in the early post-stroke stage. This pilot study evaluated the temporospatial parameters of gait and assessed the maximal isometric and isokinetic torque production of the plantar flexor and dorsiflexor muscles.
15 patients with lower limb spasticity and 15 healthy controls were included. Stroke severity was assessed using the Modified Ashworth Scale and the Barthel Index. Gait cadence, gait speed, and gait cycle were assessed using inertial sensors during a Timed Up and Go test. Maximal isometric and isokinetic torque production of the ankle plantar flexor and dorsiflexor muscles were assessed using an isokinetic dynamometer device.
Post-stroke patients had statistically significantly lower gait cadence than healthy participants (17%, p < 0.05). Statistically significantly lower values of vertical acceleration were also noted during a sit-to-stand movement task (42%, p < 0.05). Plantar flexion torque of the affected limb was significantly different during isometric (63%, p ≤ 0.01) and isokinetic work for 30o/s (49%, p = 0.04), 60o/s (58%, p = 0.01) and 20 °/s (53%, p = 0.01). Dorsiflexor muscles' torque production was significantly different in isometric activity (38%, p = 0.04). A statistically significant positive correlation occurred between the absolute peak torque of the dorsiflexor muscles in both static and speed phases of gait (Rs = 0.65, p = 0.04).
Despite the low intensity of spasticity and early phase after stroke, differences in the muscle torque production and temporo-spatial parameters, as well as the correlations between them, were noticeable.
与中风相关的偏瘫是影响步态参数的重要因素。到目前为止，有限的文献评估了中风后早期的时空能力及其与步态参数的相关性。本初步研究评估了步态的时空参数，并评估了跖屈肌和背屈肌的最大等长和等速扭矩产生。
纳入 15 例下肢痉挛患者和 15 例健康对照者。使用改良 Ashworth 量表和 Barthel 指数评估中风严重程度。在计时起立行走测试中，使用惯性传感器评估步态时相、步态速度和步态周期。使用等速测力仪评估踝跖屈肌和背屈肌的最大等长和等速扭矩产生。
中风后患者的步态时相较健康参与者显著降低（17%，p<0.05）。在从坐到站的运动任务中，垂直加速度的显著降低也被注意到（42%，p<0.05）。患侧的跖屈肌在等长（63%，p≤0.01）和 30°/s 的等速运动（49%，p=0.04）、60°/s（58%，p=0.01）和 20°/s（53%，p=0.01）时的扭矩显著不同。背屈肌在等长活动中的扭矩产生显著不同（38%，p=0.04）。在步态的静态和速度相，背屈肌的绝对峰值扭矩之间存在显著的正相关（Rs=0.65，p=0.04）。
尽管痉挛强度较低且处于中风后早期阶段，但肌肉扭矩产生和时空参数之间的差异以及它们之间的相关性仍然明显。
