Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.
Dept. of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Sweden.
Gait Posture. 2020 Oct;82:181-188. doi: 10.1016/j.gaitpost.2020.08.115. Epub 2020 Aug 29.
Whole-body movement adjustments during gait are common post-stroke, but comprehensive ways of quantifying and evaluating gait from a whole-body perspective are lacking.
Can novel kinematic variables related to Center of Mass (CoM) position discriminate side asymmetries as well as coordination between the upper and lower body during gait within persons post-stroke and compared to non-disabled controls?
Thirty-one persons post-stroke and 41 age-matched non-disabled controls walking at their self-selected speed were recorded by 3D motion capture. The Ankle-CoM Inclination Angle (A-CoMIA) and the Head-CoM Inclination Angle (H-CoMIA) defined the angle between the CoM and the ankle and the head, respectively, in the frontal plane. These angles and their angular velocities were compared between groups, and with regard to motor impairment severity during all phases of the gait cycle (GC) using a functional interval-wise testing analysis suitable for curve data. Upper and lower body coordination was assessed using cross- correlation.
The A-CoMIA was symmetrical between body sides in persons post-stroke but larger compared to controls. The angular velocity of A-CoMIA also differed when compared to controls. The H-CoMIA was consistently asymmetrical in persons post-stroke and larger than in controls throughout the stance phase. There were only minor group differences in the angular velocity of H-CoMIA, with some side asymmetry in persons post-stroke. The A-CoMIA of the non-affected side, and the H- CoMIA, discriminated between persons with more severe impairments compared to those with milder impairments post-stroke. The variables showed strong cross- correlations in both groups.
The A-CoMIA and Head-CoMIA discriminated post-stroke gait from non-disabled, as well as motor impairment severity. These variables with the advantageous curve analysis during the entire GC add valuable whole-body information to existing parameters of post-stroke gait analysis through assessment of symmetry and upper and lower body coordination.
步行时全身运动调整在中风后很常见，但缺乏全面的方法来从整体角度量化和评估步态。
与中心质量（CoM）位置相关的新运动学变量是否可以区分中风后个体的侧方不对称以及上下半身之间的协调，与非残疾对照组相比是否可以？
31 名中风后患者和 41 名年龄匹配的非残疾对照组以自己选择的速度行走，通过 3D 运动捕捉进行记录。踝关节 CoM 倾斜角（A-CoMIA）和头部 CoM 倾斜角（H-CoMIA）分别定义了 CoM 与踝关节和头部在额状面之间的角度。在整个步态周期（GC）的所有阶段，使用适合曲线数据的功能区间测试分析，比较组间以及与运动障碍严重程度的关系。使用交叉相关评估上下身协调。
中风后患者的 A-CoMIA 在身体两侧是对称的，但与对照组相比更大。A-CoMIA 的角速度也与对照组不同。中风后患者的 H-CoMIA 在整个站立阶段始终不对称，且大于对照组。H-CoMIA 的角速度在组间仅存在较小差异，中风后患者的某些侧方存在不对称。非患侧的 A-CoMIA 和 H-CoMIA 可以区分中风后严重程度更高和更低的患者。这些变量在两组中都具有很强的交叉相关性。
A-CoMIA 和 H-CoMIA 可以区分中风后步态与非残疾步态，以及运动障碍的严重程度。这些变量在整个 GC 期间具有有利的曲线分析，通过评估对称性和上下身协调，为中风后步态分析增加了有价值的整体信息。
