Salzmann Christian, Sehle Aida, Liepert Joachim
Kliniken Schmieder, Allensbach, Germany.
Lurija Institute, Allensbach, Germany.
Front Neurol. 2021 Jun 18;12:691214. doi: 10.3389/fneur.2021.691214. eCollection 2021.
The flexor reflex or withdrawal reflex can be elicited by electrical stimulation of the sole of the foot, which serves as a reflex to protect the stimulated limb against tissue damage and consists of flexion movements in the hip, knee, and ankle joint. Triggering this reflex might improve walking abilities in hemiparetic patients. We report the first case of a chronic stroke patient with the most severe impairment of walking. She was examined with and without flexor reflex activation by the Incedo® system. Tests included a 10-m walk and a 2-min walk at baseline, after 3 weeks of training with the Incedo® system and after a follow-up 3 weeks later. Moreover, a kinematic gait analysis was done before and after the training period. At baseline, activation of the flexor reflex induced an improved gait velocity. After the training period, the patient walked twice as fast compared with baseline. Her gait velocity without Incedo® was faster than the gait velocity with Incedo® at baseline. Examination at follow-up indicated that the improvements remained almost unchanged. The kinematic analysis showed an improved stride length and gait velocity during flexor reflex activation. Initially, the foot was elevated higher above the ground during flexor reflex activation. In conclusion, this first case report of a chronic stroke patient demonstrates that flexor reflex activation is feasible and improves gait parameters despite severe impairment of walking abilities.
屈肌反射或退缩反射可通过对足底进行电刺激引出，该反射用于保护受刺激肢体免受组织损伤，由髋关节、膝关节和踝关节的屈曲运动组成。触发此反射可能会改善偏瘫患者的行走能力。我们报告了首例行走能力严重受损的慢性中风患者。使用Incedo®系统对其进行了有无屈肌反射激活的检查。测试包括在基线时、使用Incedo®系统训练3周后以及3周后的随访时进行的10米步行和2分钟步行。此外，在训练期前后进行了运动步态分析。在基线时，屈肌反射的激活使步态速度得到改善。训练期后，患者行走速度比基线时快两倍。在基线时，她不使用Incedo®时的步态速度比使用Incedo®时快。随访检查表明改善几乎没有变化。运动学分析显示在屈肌反射激活期间步幅长度和步态速度有所改善。最初，在屈肌反射激活期间脚抬离地面的高度更高。总之，这例慢性中风患者的首例病例报告表明，尽管行走能力严重受损，但屈肌反射激活是可行的且能改善步态参数。
