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脑不对称性及其对偏瘫患者步态策略的影响:新的康复理念

Brain Asymmetry and Its Effects on Gait Strategies in Hemiplegic Patients: New Rehabilitative Conceptions.

作者信息

Vismara Luca, Cimolin Veronica, Buffone Francesca, Bigoni Matteo, Clerici Daniela, Cerfoglio Serena, Galli Manuela, Mauro Alessandro

机构信息

Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, 28824 Verbania, Italy.

Department of Neurosciences "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy.

出版信息

Brain Sci. 2022 Jun 18;12(6):798. doi: 10.3390/brainsci12060798.

Abstract

Brain asymmetry is connected with motor performance, suggesting that hemiparetic patients have different gait patterns depending on the side of the lesion. This retrospective cohort study aims to further investigate the difference between right and left hemiplegia in order to assess whether the injured side can influence the patient’s clinical characteristics concerning gait, thus providing insights for new personalized rehabilitation strategies. The data from 33 stroke patients (17 with left and 16 with right hemiplegia) were retrospectively compared with each other and with a control group composed of 20 unaffected age-matched individuals. The 3D gait analysis was used to assess kinematic data and spatio-temporal parameters. Compared to left hemiplegic patients, right hemiplegic patients showed worse spatio-temporal parameters (p < 0.05) and better kinematic parameters (p < 0.05). Both pathological groups were characterized by abnormal gait parameters in comparison with the control group (p < 0.05). These findings show an association between the side of the lesion—right or left—and the different stroke patients’ gait patterns: left hemiplegic patients show better spatio-temporal parameters, whereas right hemiplegic patients show better segmentary motor performances. Therefore, further studies may develop and assess new personalized rehabilitation strategies considering the injured hemisphere and brain asymmetry.

摘要

脑不对称与运动表现相关,这表明偏瘫患者根据病变部位的不同具有不同的步态模式。这项回顾性队列研究旨在进一步探究右侧偏瘫和左侧偏瘫之间的差异,以评估损伤侧是否会影响患者在步态方面的临床特征,从而为新的个性化康复策略提供见解。对33例中风患者(17例左侧偏瘫和16例右侧偏瘫)的数据进行回顾性比较,并与由20名年龄匹配的未受影响个体组成的对照组进行比较。采用三维步态分析来评估运动学数据和时空参数。与左侧偏瘫患者相比,右侧偏瘫患者的时空参数更差(p<0.05),而运动学参数更好(p<0.05)。与对照组相比,两个病理组的步态参数均异常(p<0.05)。这些发现表明病变部位(右侧或左侧)与不同中风患者的步态模式之间存在关联:左侧偏瘫患者的时空参数更好,而右侧偏瘫患者的节段性运动表现更好。因此,未来的研究可能会基于受损半球和脑不对称性来开发和评估新的个性化康复策略。

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