Department of Biomedical Engineering, University of Delaware, Newark, DE, USA.
Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.
Gait Posture. 2021 May;86:256-259. doi: 10.1016/j.gaitpost.2021.03.031. Epub 2021 Mar 26.
Walking with user-driven treadmill control is believed to be more like overground walking than fixed-speed treadmill walking. Walking speed and ground reaction forces differ between overground and fixed-speed treadmill walking, but not between overground and user-driven treadmill walking in healthy and post-stroke subjects. However, studies assessing spatiotemporal gait parameters during user-driven treadmill walking are limited. This information may help confirm that user-driven treadmill walking is more like overground walking than fixed-speed treadmill walking, as well as inform the development of post-stroke gait rehabilitation programs.
How do spatiotemporal gait parameters for individuals post-stroke differ between fixed-speed and user-driven treadmill walking?
Eighteen subjects (10 M, 8 F; 62 ± 12 years; 1.73 ± 0.12 m; 84.9 ± 12.9 kg; 40 ± 30 months post-stroke) with chronic post-stroke hemiparesis participated in this study. Participants walked on an instrumented treadmill in its fixed-speed and user-driven modes at their self-selected and fastest comfortable walking speeds. Subjects wore retroreflective markers for motion capture. Shapiro-Wilk tests were used to assess for normality and one-way repeated measures ANOVAs were used to compare between conditions with α = 0.05. Bonferroni corrections were used for multiple comparisons.
Step width was significantly smaller with user-driven control (13.7 cm, 95 % CI: [0.131, 0.145]) than fixed-speed control (16.8 cm, 95 % CI:[0.160, 0.174]), while step length and step time did not differ across treadmill conditions. Step length and step time differed between self-selected and fast walking speeds, but not treadmill control conditions.
The results of this study show that user-driven treadmill control encourages healthy gait biomechanics and a greater sense of stability in post-stroke subjects. Individuals post-stroke walked with smaller step width with user-driven treadmill control, which has been associated with increased balance. Post-stroke gait rehabilitation may benefit from programs with user-driven treadmill training paradigms to improve mobility following stroke.
与固定速度跑步机相比，使用者驱动的跑步机控制更类似于在地面上行走。在健康人和脑卒中后患者中，与地面行走相比，跑步机行走的速度和地面反作用力不同，但与使用者驱动的跑步机行走不同。然而，评估使用者驱动的跑步机行走时空步态参数的研究有限。这些信息可能有助于确认使用者驱动的跑步机行走比固定速度跑步机行走更类似于地面行走，并且为脑卒中后步态康复计划的发展提供信息。
脑卒中后个体在固定速度和使用者驱动的跑步机行走之间的时空步态参数有何不同？
本研究纳入了 18 名慢性脑卒中偏瘫患者（10 名男性，8 名女性；62±12 岁；1.73±0.12m；84.9±12.9kg；脑卒中后 40±30 个月）。参与者在仪器化跑步机上以其自我选择的和最快舒适的步行速度在固定速度和使用者驱动模式下行走。受试者穿着用于运动捕捉的反射标记物。使用 Shapiro-Wilk 检验评估正态性，使用单向重复测量方差分析比较条件之间的差异，α=0.05。使用 Bonferroni 校正进行多重比较。
与固定速度控制（16.8cm，95%CI：[0.160,0.174]）相比，使用者驱动控制时步宽显著减小（13.7cm，95%CI：[0.131,0.145]），而步长和步时在两种跑步机条件下没有差异。步长和步时在自我选择和快速行走速度之间有所不同，但在跑步机控制条件下没有差异。
这项研究的结果表明，使用者驱动的跑步机控制鼓励脑卒中后患者进行健康的步态生物力学和更大的稳定性感。与固定速度跑步机相比，使用者驱动跑步机控制时脑卒中患者的步宽更小，这与平衡能力提高有关。脑卒中后步态康复可能受益于具有使用者驱动的跑步机训练模式的计划，以改善脑卒中后的移动能力。
