Fujita Kazuki, Kobayashi Yasutaka, Hitosugi Masahito
Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui 910-3190, Japan.
Department of Legal Medicine, Shiga University of Medical Science, Shiga 520-2192, Japan.
Healthcare (Basel). 2021 Apr 10;9(4):444. doi: 10.3390/healthcare9040444.
Abnormal gait, particularly in patients with stroke, causes neuromuscular fatigue. We aimed to clarify temporal changes in gait performance and lower limb muscle activity during extended walking in people with stroke hemiplegia. Twelve adults with stroke and eleven healthy controls performed an extended trial involving 20-min continuous walk at a comfortable speed. The primary outcome was electromyography amplitude during the trial and secondary outcomes were walking performance and the instantaneous mean frequency of electromyography during the trial. Data at 1, 6, 12, and 18 min after initiating walking were compared. Performance during extended walking in people with stroke was maintained over time. The electromyography amplitude decreased in the tibialis anterior during the pre-swing phase and increased in the rectus femoris during the single-support phase over time; these changes were similar on the paretic and nonparetic sides. Instantaneous mean frequency decreased over time on the nonparetic side in the tibialis anterior and on the paretic side in the rectus femoris. Healthy subjects did not show any changes over time. The changes in muscle activity in patients with stroke differed between the paretic and nonparetic sides, muscle type, and gait phase; walking performance was maintained despite being affected by neuromuscular fatigue.
异常步态，尤其是中风患者的异常步态，会导致神经肌肉疲劳。我们旨在阐明中风偏瘫患者长时间行走过程中步态表现和下肢肌肉活动的时间变化。12名中风成年人和11名健康对照者进行了一项扩展试验，以舒适的速度连续行走20分钟。主要结果是试验期间的肌电图幅度，次要结果是行走表现和试验期间肌电图的瞬时平均频率。比较了开始行走后1、6、12和18分钟的数据。中风患者长时间行走期间的表现随时间保持稳定。随着时间的推移，摆动前期胫前肌的肌电图幅度降低，单支撑期股直肌的肌电图幅度增加；这些变化在患侧和非患侧相似。非患侧胫前肌和患侧股直肌的瞬时平均频率随时间降低。健康受试者未表现出随时间的任何变化。中风患者肌肉活动的变化在患侧和非患侧、肌肉类型和步态阶段之间存在差异；尽管受到神经肌肉疲劳的影响，但行走表现仍得以维持。
