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根据偏瘫脑卒中患者使用的不同类型拐杖,下肢肌肉激活和承重程度的变化。

Changes in Lower Limb Muscle Activation and Degree of Weight Support according to Types of Cane-Supported Gait in Hemiparetic Stroke Patients.

机构信息

Department of Physical Therapy, Korea National University of Transportation, 61 Daehak-ro, Jeungpyeong-gun, Chungbuk 27909, Republic of Korea.

出版信息

Biomed Res Int. 2020 Sep 23;2020:9127610. doi: 10.1155/2020/9127610. eCollection 2020.

Abstract

This study was aimed at investigating the changes in the degree of weight support loaded on the cane and paretic-side lower limb muscle activation according to the types of cane and cane-supported gait using a weight-support feedback cane (WSFC). Eleven hemiparetic stroke patients were recruited from a local rehabilitation hospital. WSFC can measure the degree of weight support loaded on the cane during cane-supported walking in units of kg, through a force sensor installed inside the handle. This study measured the degree of weight support loaded on the cane and lower limb muscle activation under four conditions: two-point and three-point gait with mono and quadripod canes. In the two-point gait with mono and quadripod canes, subjects were asked to move the WSFC and paretic-side foot forward at the same time and then move the nonparetic-side foot. In the three-point gait with mono and quadripod canes, subjects were asked to first move the WSFC forward, then the paretic-side foot, and finally the nonparetic-side foot. The degree of weight support loaded on the cane was significantly higher in the three-point gait with WSFC than in the two-point gait with WSFC for both mono ( = .047) and quadripod canes ( = .002). Additionally, the paretic-side lower limb muscle activation during the stance phase was significantly higher in the two-point gait with WSFC than in the three-point gait with WSFC for both mono ( = .008 ~ .044) and quadripod canes ( = .008 ~ .026). Our results suggest that applying the three-point gait with high cane dependence in the early stages of training for stability and subsequently applying the two-point gait for the enhancement of lower limb muscle activation and training of normal gait pattern could be effective.

摘要

本研究旨在通过使用负重反馈手杖(Weight-Support Feedback Cane,WSFC),调查手杖类型和手杖支撑步态下手杖上的负重程度以及患侧下肢肌肉激活的变化。从当地康复医院招募了 11 名偏瘫脑卒中患者。WSFC 通过安装在手柄内的力传感器,以公斤为单位测量手杖支撑步行时手杖上的负重程度。本研究在四种情况下测量了手杖上的负重程度和下肢肌肉激活:两点步态和三点步态,分别使用单足和四足手杖。在使用单足和四足手杖的两点步态中,要求患者同时将 WSFC 和患侧脚向前移动,然后移动非患侧脚。在使用单足和四足手杖的三点步态中,要求患者先向前移动 WSFC,然后移动患侧脚,最后移动非患侧脚。在 WSFC 的三点步态中,手杖上的负重程度显著高于 WSFC 的两点步态,无论是单足(=.047)还是四足手杖(=.002)。此外,在 WSFC 的两点步态中,患侧下肢肌肉在支撑期的激活显著高于 WSFC 的三点步态,无论是单足(=.008.044)还是四足手杖(=.008.026)。我们的结果表明,在训练的早期阶段应用高依赖手杖的三点步态以提高稳定性,随后应用两点步态以增强下肢肌肉激活和训练正常步态模式可能是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab3b/7530500/dec73cc6c5ae/BMRI2020-9127610.001.jpg

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