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蹬踏运动可改善偏瘫患者膝关节僵硬步态的行走能力:预防步态期间跌倒。

Pedaling improves gait ability of hemiparetic patients with stiff-knee gait: fall prevention during gait.

作者信息

Fujita Kazuki, Kobayashi Yasutaka, Miaki Hiroichi, Hori Hideaki, Tsushima Yuichi, Sakai Ryo, Nomura Tomomi, Ogawa Tomoki, Kinoshita Hirotaka, Nishida Tomoko, Hitosugi Masahito

机构信息

Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, 55-13-1 Egami, Fukui-city 910-3190, Fukui, Japan.

Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa-city, Ishikawa, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105035. doi: 10.1016/j.jstrokecerebrovasdis.2020.105035. Epub 2020 Jun 28.

Abstract

BACKGROUND AND PURPOSE

Stiff-knee gait, which is a gait abnormality observed after stroke, is characterized by decreased knee flexion angles during the swing phase, and it contributes to a decline in gait ability. This study aimed to identify the immediate effects of pedaling exercises on stiff-knee gait from a kinesiophysiological perspective.

METHODS

Twenty-one patients with chronic post-stroke hemiparesis and stiff-knee gait were randomly assigned to a pedaling group and a walking group. An ergometer was set at a load of 5 Nm and rotation speed of 40 rpm, and gait was performed at a comfortable speed; both the groups performed the intervention for 10 min. Kinematic and electromyographical data while walking on flat surfaces were immediately measured before and after the intervention.

RESULTS

In the pedaling group, activity of the rectus femoris significantly decreased from the pre-swing phase to the early swing phase during gait after the intervention. Flexion angles and flexion angular velocities of the knee and hip joints significantly increased during the same period. The pedaling group showed increased step length on the paralyzed side and gait velocity.

CONCLUSIONS

Pedaling increases knee flexion during the swing phase in hemiparetic patients with stiff-knee gait and improves gait ability.

摘要

背景与目的

膝关节僵硬步态是中风后观察到的一种步态异常,其特征是摆动期膝关节屈曲角度减小,这会导致步态能力下降。本研究旨在从运动生理角度确定蹬踏运动对膝关节僵硬步态的即时影响。

方法

将21例慢性中风后偏瘫且伴有膝关节僵硬步态的患者随机分为蹬踏组和步行组。测力计设置为5牛米的负荷和40转/分钟的转速,以舒适速度进行步态训练;两组均进行10分钟的干预。在干预前后立即测量在平坦表面行走时的运动学和肌电图数据。

结果

在蹬踏组中,干预后步态期间,股直肌的活动从摆动前期到摆动早期显著降低。同期膝关节和髋关节的屈曲角度和屈曲角速度显著增加。蹬踏组患侧步长和步态速度增加。

结论

蹬踏可增加偏瘫且伴有膝关节僵硬步态患者摆动期的膝关节屈曲,并改善步态能力。

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