Ma Min Kyeong, Cho TaeHwan, Lee Joo Won, Moon Hyun Im
Department of Rehabilitation Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea.
Ann Rehabil Med. 2023 Aug;47(4):291-299. doi: 10.5535/arm.23061. Epub 2023 Aug 28.
To investigate the relationship between the torque onset angle (TOA) of the isokinetic test for knee extensors in the paretic side and walking related balance in subacute stroke patients.
We retrospectively reviewed patients with first-ever strokes who have had at least two isokinetic tests within 6 months of onset. 102 patients satisfied the inclusion criteria. The characteristics of walking related balance were measured with the Berg Balance Scale sub-score (sBBS), Timed Up and Go test (TUG), 10-m Walk Test (10MWT) and Functional Independence Measure sub-score (sFIM). The second isokinetic test values of the knee extensor such as peak torque, peak torque to weight ratio, hamstring/quadriceps ratio, TOA, torque stop angle, torque at 30 degrees, and peak torque asymmetry ratio between paretic and non-paretic limb were also taken into account. Pearson's correlation, simple regression and multiple regression analysis were used to analyze the correlation between TOA and walking related balance.
TOA of the knee extensor of the paretic limb showed significant correlations with BBS, sBBS, TUG, 10MWT, and sFIM according to Pearson's correlation analysis. TOA also had moderate to good correlations with walking related balance parameters in partial correlation analysis. In multiple regression analysis, TOA of the paretic knee extensor was significantly associated with walking related balance parameters.
This study demonstrated that TOA of the paretic knee extensor is a predictable parameter of walking related balance. Moreover, we suggest that the ability to recruit muscle quickly is important in walking related balance.
探讨亚急性脑卒中患者患侧膝伸肌等速测试的力矩起始角度(TOA)与步行相关平衡之间的关系。
我们回顾性分析了首次发生卒中且在发病6个月内至少进行过两次等速测试的患者。102例患者符合纳入标准。采用伯格平衡量表分项评分(sBBS)、计时起立行走测试(TUG)、10米步行测试(10MWT)和功能独立性测量分项评分(sFIM)来测量步行相关平衡的特征。还考虑了膝伸肌的第二次等速测试值,如峰值力矩、峰值力矩与体重比、腘绳肌/股四头肌比值、TOA、力矩终止角度、30度时的力矩以及患侧与健侧肢体之间的峰值力矩不对称率。采用Pearson相关性分析、简单回归分析和多元回归分析来分析TOA与步行相关平衡之间的相关性。
根据Pearson相关性分析,患侧肢体膝伸肌的TOA与BBS、sBBS、TUG、10MWT和sFIM均显示出显著相关性。在偏相关性分析中,TOA与步行相关平衡参数也具有中度至良好的相关性。在多元回归分析中,患侧膝伸肌的TOA与步行相关平衡参数显著相关。
本研究表明,患侧膝伸肌的TOA是步行相关平衡的一个可预测参数。此外,我们认为快速募集肌肉的能力在步行相关平衡中很重要。