He Jian, Liu Dongwei, Hou Meijin, Luo Anhua, Wang Shuhao, Ma Ye
Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, Zhejiang, China.
School of Information Management and Artificial Intelligence, Zhejiang University of Finance and Economics, Hangzhou, Zhejiang, China.
BMC Sports Sci Med Rehabil. 2023 Aug 16;15(1):104. doi: 10.1186/s13102-023-00716-1.
Inter-joint coordination is an important factor affecting postural stability, and its variability increases after fatigue. This study aimed to investigate the coordination pattern of lower limb joints during the sit-to-stand (Si-St) and stand-to-sit (St-Si) tasks in stroke patients and explore the influence of duration on inter-joint coordination.
Thirteen stroke hemiplegia patients (five with left paretic and eight right paretic) and thirteen age-matched healthy subjects were recruited. The Si-St and St-Si tasks were performed while each subject's joint kinematics were recorded using a three-dimensional motion capture system. Sagittal joint angles of the bilateral hip, knee and ankle joints as well as the movement duration were extracted. The angle-angle diagrams for the hip-knee, hip-ankle and knee-ankle joint were plotted to assess the inter-joint coordination. The inter-joint coordination was quantified using geometric characteristics of the angle-angle diagrams, including perimeter, area and dimensionless ratio. The coefficient of variation (CV) was performed to compare variability of the coordination parameters.
There were no significant differences in the perimeter, area and dimensionless ratio values of the bilateral hip-knee, hip-ankle and knee-ankle inter-joints during Si-St and St-Si tasks in the stroke group. The perimeter values of bilateral hip-knee and knee-ankle inter-joints in the stroke group were lower (P<0.05) than in the healthy group during Si-St and St-Si tasks. Although no significant bilateral differences were found, the inter-joint coordination in stroke patients decreased with the increased movement duration of both Si-St and St-Si tasks. Additionally, the CV of the hip-knee inter-joint area during the Si-St task in the stroke group was less than (P<0.05) that in the healthy group.
Stroke patients exhibit different inter-joint coordination patterns than healthy controls during the Si-St and St-Si tasks. The duration affects joint coordination, and inter-joint coordination is limited on the hemiplegic side joint pairs, which may lead to inconsistency in the rhythm of the left and right leg inter-joint movements and increase the risk of falls. These findings provide new insights into motor control rehabilitation strategies and may help planning targeted interventions for stoke patients with hemiplegia.
关节间协调是影响姿势稳定性的重要因素，疲劳后其变异性增加。本研究旨在调查中风患者在坐立（Si-St）和站立坐立（St-Si）任务期间下肢关节的协调模式，并探讨持续时间对关节间协调的影响。
招募了13名中风偏瘫患者（5名左侧偏瘫和8名右侧偏瘫）和13名年龄匹配的健康受试者。在每个受试者使用三维运动捕捉系统记录关节运动学的同时进行Si-St和St-Si任务。提取双侧髋、膝和踝关节的矢状关节角度以及运动持续时间。绘制髋-膝、髋-踝和膝-踝关节的角度-角度图以评估关节间协调。使用角度-角度图的几何特征（包括周长、面积和无量纲比率）对关节间协调进行量化。进行变异系数（CV）以比较协调参数的变异性。
中风组在Si-St和St-Si任务期间，双侧髋-膝、髋-踝和膝-踝关节间的周长、面积和无量纲比率值无显著差异。中风组在Si-St和St-Si任务期间，双侧髋-膝和膝-踝关节间的周长值低于健康组（P<0.05）。虽然未发现显著的双侧差异，但中风患者的关节间协调随着Si-St和St-Si任务运动持续时间的增加而降低。此外，中风组在Si-St任务期间髋-膝关节间面积的CV小于健康组（P<0.05）。
中风患者在Si-St和St-Si任务期间表现出与健康对照不同的关节间协调模式。持续时间影响关节协调，偏瘫侧关节对的关节间协调受限，这可能导致左右腿关节间运动节奏不一致并增加跌倒风险。这些发现为运动控制康复策略提供了新见解，并可能有助于为偏瘫中风患者规划有针对性的干预措施。
