Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA.
J Stroke Cerebrovasc Dis. 2023 Apr;32(4):107035. doi: 10.1016/j.jstrokecerebrovasdis.2023.107035. Epub 2023 Feb 3.
The goal of this study was to determine whether enhanced phasic sensory afferent input paired with the application of controlled constraint force during walking would improve weight shift toward the paretic side and enhance use of the paretic leg.
Fourteen stroke survivors participated in two experimental conditions, sessions that consisted of 1 min treadmill walking without force and stimulation (baseline), 7 min walking with either "constraint force and sensory stimulation (constraint+stim)" or "constraint force only (constraint)" (adaptation), and then 2 min walking without force and stimulation (post-adaptation). Kinematics of the pelvis and legs, and muscle activity of the paretic leg were recorded.
Participants showed greater increases in hip abductor (p < 0.001) and adductor (p = 0.04) muscle activities, weight shift toward the paretic side (p = 0.002), and step length symmetry (p < 0.01) during the late post-adaptation period in the "constraint+stim" condition, compared with the effect of the "constraint" condition. In addition, changes in overground walking speed from baseline to 10 min post treadmill walking was significantly greater for the "constraint force and stimulation" condition than for the "constraint force only" condition (p = 0.04).
Enhanced targeted sensory afferent input during locomotor training may facilitate recruitment of targeted muscles of the paretic leg and facilitate use-dependent motor learning of locomotor tasks, which might retain longer and partially transfer from treadmill to overground walking, in stroke survivors.
本研究旨在确定在行走过程中增强相位感觉传入输入并施加受控约束力是否会改善向患侧的体重转移，并增强患侧下肢的使用。
14 名脑卒中幸存者参与了两种实验条件，分别为无外力和刺激的跑步机行走 1 分钟（基线）、7 分钟的步行，包括“约束力和感觉刺激（约束+刺激）”或“仅约束力（约束）”（适应），然后无外力和刺激行走 2 分钟（适应后）。记录骨盆和腿部的运动学以及患侧腿部的肌肉活动。
与“约束”条件相比，在“约束+刺激”条件下，参与者在适应后期的髋关节外展肌（p < 0.001）和内收肌（p = 0.04）、向患侧的体重转移（p = 0.002）和步长对称性（p < 0.01）的增加更大。此外，从基线到跑步机行走 10 分钟后的地面行走速度的变化在“约束力和刺激”条件下比在“仅约束力”条件下显著更大（p = 0.04）。
在运动训练过程中增强靶向感觉传入输入可能有助于募集靶向患侧下肢的肌肉，并促进运动任务的依赖于使用的运动学习，这可能在脑卒中幸存者中保留时间更长，并部分从跑步机转移到地面行走。
