Tsushima Yuichi, Fujita Kazuki, Miaki Hiroichi, Kobayashi Yasutaka
Department of Physical Therapy Rehabilitation, Fukui General Hospital: 58-16-1 Egami, Fukui-city, Fukui 910-8651, Japan.
Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Japan.
J Phys Ther Sci. 2022 Aug;34(8):590-595. doi: 10.1589/jpts.34.590. Epub 2022 Aug 3.
[Purpose] Gait training that increases non-paretic step length in stroke patients increases the propulsive force of the paretic leg. However, it limits knee flexion during the swing phase of gait, and this may cause gait disturbances such as worsening of gait pattern and increased risk of falling. Therefore, this study aimed to investigate the effects of increasing non-paretic step length on the joint movement and muscle activity of a paretic lower limb during hemiparetic gait. [Participants and Methods] A total of 15 hemiparetic patients with chronic stroke were enrolled in this study. Spatiotemporal parameters, along with kinematic and electromyography data of their paretic lower limbs, were measured during a 10-m distance overground walking. Two walking conditions were assessed: normal (comfortable gait) and non-paretic-long (gait with increased non-paretic step length) conditions. [Results] Under the non-paretic-long condition, the trailing limb angle was larger than under the normal condition. However, no significant difference was observed in the knee flexion angle during the swing phase. [Conclusion] Increasing non-paretic step length during gait is unlikely to limit knee flexion during the swing phase and can safely improve the propulsive force of a paretic leg.
[目的] 增加中风患者非患侧步长的步态训练可增加患侧腿的推进力。然而，它会限制步态摆动期的膝关节屈曲，这可能会导致步态紊乱，如步态模式恶化和跌倒风险增加。因此，本研究旨在探讨增加非患侧步长对偏瘫步态中患侧下肢关节运动和肌肉活动的影响。[参与者与方法] 本研究共纳入15例慢性中风偏瘫患者。在10米的地面行走过程中，测量了他们患侧下肢的时空参数以及运动学和肌电图数据。评估了两种行走条件：正常（舒适步态）和非患侧长步（非患侧步长增加的步态）条件。[结果] 在非患侧长步条件下，后肢角度大于正常条件下。然而，摆动期膝关节屈曲角度未观察到显著差异。[结论] 在步态中增加非患侧步长不太可能限制摆动期膝关节屈曲，并且可以安全地提高患侧腿的推进力。
