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根据慢性中风患者对拐杖的依赖程度,下肢肌肉活动和步态功能的变化。

Changes in lower limb muscle activation and gait function according to cane dependence in chronic stroke patients.

机构信息

Department of Physical Therapy, Graduate School, Korea National University of Transportation, Republic of Korea.

Department of Physical Therapy, Korea National University of Transportation, Republic of Korea.

出版信息

Technol Health Care. 2021;29(1):133-141. doi: 10.3233/THC-192075.

Abstract

BACKGROUND

Few quantitative analyses have been performed on muscle activation and gait function according to cane dependence.

OBJECTIVE

The purpose of this study was to measure changes in the lower limb muscle activation and gait function according to reduced cane dependence using a weight-bearing feedback cane (WBFC) that had been designed to quantitatively measure cane dependence in stroke patients during walking.

METHODS

Twenty-four subjects were recruited from a local rehabilitation hospital. The WBFC measured the average weight support (AWS, kg) loaded on the cane during walking through a Bluetooth connection to laptop software. All subjects walked 20 m using a WBFC set in the three levels of weight support (WSR, 100%, 60%, and 20%) based on the measured AWS. Paretic lower limb muscle activation and gait function (velocity, cadence, paretic side stride length, and symmetry index) were measured using wireless surface EMG and a 3-axis accelerometer during walking.

RESULTS

The paretic side lower limb muscle activation of the 20% WSR on the cane was significantly higher than that of the 100% WSR on the cane (p< 0.05). Gait functions of the 20% WSR on the cane were significantly lower than those of the 100% WSR on the cane (p< 0.05).

CONCLUSION

These findings suggest that indiscreet weight support on the cane during walking can interfere with lower limb muscle activation and gait function. Therefore, in a clinical setting, reducing cane dependence during stroke gait training should be carefully considered.

摘要

背景

根据对拐杖的依赖程度,很少对肌肉激活和步态功能进行定量分析。

目的

本研究旨在使用一种旨在定量测量中风患者行走时拐杖依赖程度的负重反馈拐杖(WBFC),测量下肢肌肉激活和步态功能根据减少拐杖依赖而发生的变化。

方法

从当地康复医院招募了 24 名受试者。WBFC 通过蓝牙连接到笔记本电脑软件,测量行走过程中拐杖上的平均承重(AWS,kg)。所有受试者均使用根据测量的 AWS 设置的三种承重水平(WSR,100%、60%和 20%)的 WBFC 行走 20m。在行走过程中,使用无线表面肌电图和三轴加速度计测量患侧下肢肌肉激活和步态功能(速度、步频、患侧步长和对称指数)。

结果

拐杖上 20% WSR 的患侧下肢肌肉激活明显高于拐杖上 100% WSR 的肌肉激活(p<0.05)。拐杖上 20% WSR 的步态功能明显低于拐杖上 100% WSR 的步态功能(p<0.05)。

结论

这些发现表明,在行走过程中不恰当地支撑拐杖会干扰下肢肌肉激活和步态功能。因此,在临床环境中,在中风步态训练中应谨慎考虑减少对拐杖的依赖。

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