Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Japan.
Department of Rehabilitation, Kita-Fukushima Medical Center, Japan.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104998. doi: 10.1016/j.jstrokecerebrovasdis.2020.104998. Epub 2020 Jun 13.
Little is known about the existence and impact of interactions among multiple impairments to gait independence. The purpose of this study is to reveal the interaction of physical functions and its impact on gait independence in stroke patients.
This retrospective study included 108 subacute stroke patients. We conducted a decision tree analysis to examine the existence of interactions in relation to gait independence among the gross motor function of lower limb, knee extension strength, sensory function, and trunk function. Further, we confirmed the existence and impact of interaction detected via the decision tree after adjusting for the effects of confounding factors using logistic regression.
The knee extension strength and proprioception on the affected side were selected in the first and second level of the decision tree. In addition, the knee extension strength was selected in the third level. The interaction of the knee extension strength and proprioception on the affected side was significantly associated with gait independence, both before and after adjusting for age, visuospatial perception, and cognitive functions.
Our results suggest that the interaction of the knee extension strength and proprioception on the affected side is strongly associated with gait independence in stroke patients.
对于多种影响步态独立性的损伤之间的相互作用的存在及其影响,目前知之甚少。本研究旨在揭示物理功能的相互作用及其对脑卒中患者步态独立性的影响。
本回顾性研究纳入了 108 例亚急性期脑卒中患者。我们进行决策树分析,以检查下肢运动功能、膝关节伸展力量、感觉功能和躯干功能与步态独立性之间相互作用的存在。此外,我们使用逻辑回归在调整混杂因素的影响后,对通过决策树检测到的相互作用的存在及其影响进行了确认。
在决策树的第一和第二级中选择了患侧的膝关节伸展力量和本体感觉。此外,在第三级中选择了膝关节伸展力量。患侧膝关节伸展力量和本体感觉之间的相互作用与步态独立性显著相关,在调整年龄、视空间感知和认知功能后仍然如此。
我们的结果表明,患侧膝关节伸展力量和本体感觉之间的相互作用与脑卒中患者的步态独立性密切相关。