Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; The Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Radiology, Jing'an District Center Hospital, Fudan University, Shanghai, China.
J Manipulative Physiol Ther. 2021 Nov-Dec;44(9):734-742. doi: 10.1016/j.jmpt.2022.03.004. Epub 2022 Jun 22.
The purpose of this study was to explore impairment and compensation characteristics of static balance and plantar load distribution in patients with chronic stroke.
We recruited 68 patients who had chronic stroke who could stand independently (stroke group) and 30 healthy individuals (control group) with the Zebris FDM platform. Static balance parameters, including center of pressure (COP) ellipse sway area, COP path length, and angle-θ between y and major axis, were compared between 2 groups under standard standing posture. In the stroke group, balance parameters were re-tested under their preferring standing posture. Plantar load distribution was also assessed. Another 8 patients with chronic stroke who could not stand independently and had to rely on a crutch were enrolled to analyze the characteristics of balance compensation.
In the stroke group, the ellipse sway area, COP path length, and angle-θ were significantly larger than those of the control group. Sixty-one (89.7%) patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing. All patients who could not stand independently tended to compensate for balance with a crutch supporting laterally and also preferred standing with a typical posture- the affected foot was outward-forward.
In patients post stroke, static balance is impaired mainly at the lateral direction, and patients commonly locate the crutch laterally for compensation of lateral balance. Patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing, which challenged the necessity of training standing symmetrically.
本研究旨在探讨慢性脑卒中患者静态平衡和足底负荷分布的障碍和代偿特征。
我们招募了 68 名能够独立站立的慢性脑卒中患者（脑卒中组）和 30 名健康个体（对照组），使用 Zebris FDM 平台进行测试。在标准站立姿势下，比较 2 组间的静态平衡参数，包括压力中心（COP）椭圆摆动面积、COP 路径长度和 y 与长轴之间的角度-θ。在脑卒中组中，在患者偏爱的站立姿势下重新测试平衡参数。还评估了足底负荷分布。另外招募了 8 名不能独立站立且需要依靠拐杖的慢性脑卒中患者，以分析平衡代偿的特征。
脑卒中组的椭圆摆动面积、COP 路径长度和角度-θ 均显著大于对照组。61 名（89.7%）患者偏爱患足向外-前支撑的站立姿势，其偏爱的站立平衡优于标准站立。所有不能独立站立的患者均倾向于使用拐杖侧向支撑来代偿平衡，也偏爱患足向外-前的典型站立姿势。
脑卒中后患者的静态平衡主要在侧向受到损害，患者通常将拐杖放置在侧向以代偿侧向平衡。患者偏爱患足向外-前支撑的站立姿势，且其偏爱的站立平衡优于标准站立，这对对称站立训练的必要性提出了挑战。
