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可穿戴式踝部弹力带步态训练对偏瘫性脑卒中患者踝关节运动学及运动控制的有效性

Effectiveness of a wearable ankle-tubing gait training on ankle kinematics and motor control in hemiparetic stroke.

作者信息

Lee Jeong Jae, Park Chanhee, You Joshua Sung H

机构信息

Rehabilitation Team, Myongji Hospital, Goyang, Republic of Korea.

Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.

出版信息

NeuroRehabilitation. 2022;51(1):123-132. doi: 10.3233/NRE-210277.

Abstract

BACKGROUND

While excessive ankle plantarflexion is a common neuromuscular impairment resulting from insufficient coordination of selective ankle neuromotor control and kinematics during gait. We recently developed a wearable, inexpensive and sustainable wearable ankle-tubing gait training (WAGT) aimed at improving selective ankle motor control and kinematic coordination.

OBJECTIVE

We investigated the effects of WAGT on tibialis anterior (TA) and gastrocnemius (GCM) muscle electromyography (EMG) activity, TA: GCM muscle imbalance ratio, and ankle joint kinematics during gait in hemiparetic stroke patients.

METHODS

A convenience sample of 33 participants (15 non-stroke healthy adults and 18 hemiparetic stroke patients) underwent standardized electromyography and kinematic biomechanical tests under conventional gait training (CGT) and WAGT conditions. Analysis of variance (ANOVA) was used to determine the significance of differences in the TA: GCM muscle activation, muscle imbalance ratio, and ankle joint kinematics before and after the intervention and between the two groups at P < 0.05.

RESULTS

WAGT was more effective than CGT in improving TA muscle activation (P < 0.01), TA: GCM muscle imbalance ratio (P < 0.01), and kinematic movement (P < 0.01) in adults with or without hemiparetic stroke.

CONCLUSIONS

This study demonstrated that WAGT is relatively ease to design, wear and affordable to most clinicians and patients, hence it is suitable for many health care applications to correct gait-related movement abnormalities presented in the hemiparetic stroke patients.

摘要

背景

虽然踝关节过度跖屈是一种常见的神经肌肉损伤,是由于步态期间选择性踝关节神经运动控制和运动学协调不足所致。我们最近开发了一种可穿戴、价格低廉且可持续的可穿戴式踝关节弹力带步态训练(WAGT),旨在改善选择性踝关节运动控制和运动学协调。

目的

我们研究了WAGT对偏瘫性中风患者步态期间胫前肌(TA)和腓肠肌(GCM)肌电图(EMG)活动、TA:GCM肌肉失衡率以及踝关节运动学的影响。

方法

一个由33名参与者(15名非中风健康成年人和18名偏瘫性中风患者)组成的便利样本,在传统步态训练(CGT)和WAGT条件下接受了标准化肌电图和运动学生物力学测试。采用方差分析(ANOVA)来确定干预前后以及两组之间TA:GCM肌肉激活、肌肉失衡率和踝关节运动学差异的显著性,P<0.05。

结果

在有或没有偏瘫性中风的成年人中,WAGT在改善TA肌肉激活(P<0.01)、TA:GCM肌肉失衡率(P<0.01)和运动学运动(P<0.01)方面比CGT更有效。

结论

本研究表明,WAGT相对易于设计、穿戴,且大多数临床医生和患者都能负担得起,因此它适用于许多医疗保健应用,以纠正偏瘫性中风患者出现的与步态相关的运动异常。

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