IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy.
Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy.
Int J Environ Res Public Health. 2022 Oct 18;19(20):13440. doi: 10.3390/ijerph192013440.
The use of quantitative methods to analyze the loss in gait smoothness, an increase in movement intermittency which is a distinguishing hallmark of motor deficits in stroke patients, has gained considerable attention in recent years. In the literature, the spectral arc length (SPARC), as well as metrics based on the measurement of the jerk, such as the log dimensionless jerk (LDLJ), are currently employed to assess smoothness. However, the optimal measure for evaluating the smoothness of walking in stroke patients remains unknown. Here, we investigated the smoothness of the body's center of mass (BCoM) trajectory during gait, using an optoelectronic system, in twenty-two subacute and eight chronic patients before and after a two-month rehabilitation program. The two measures were evaluated for their discriminant validity (ability to differentiate the smoothness of the BCoM trajectory calculated on the cycle of the affected and unaffected limb, and between subacute and chronic patients), validity (correlation with clinical scales), and responsiveness to the intervention. According to our findings, the LDLJ outperformed the SPARC in terms of the examined qualities. Based on data gathered using an optoelectronic system, we recommend using the LDLJ rather than the SPARC to investigate the gait smoothness of stroke patients.
近年来，使用定量方法分析步态平滑度的损失，以及运动间歇性的增加（这是中风患者运动缺陷的一个显著特征），已经引起了相当多的关注。在文献中，光谱弧长（SPARC）以及基于冲击测量的指标，如对数无量纲冲击（LDLJ），目前被用于评估平滑度。然而，评估中风患者行走平滑度的最佳方法仍不清楚。在这里，我们使用光电系统研究了二十二名亚急性期和八名慢性期中风患者在为期两个月的康复计划前后，身体质心（BCoM）轨迹的平滑度。我们评估了这两种方法的判别有效性（区分受影响和未受影响肢体的 BCoM 轨迹以及区分亚急性和慢性患者的平滑度的能力）、有效性（与临床量表的相关性）和对干预的反应能力。根据我们的发现，LDLJ 在检查质量方面优于 SPARC。基于使用光电系统收集的数据，我们建议使用 LDLJ 而不是 SPARC 来研究中风患者的步态平滑度。
