Ryu Jin-Whan, Hwang In-Su, Jin Sol, Kim Soo-A, Kim Min-Su
Department of Rehabilitation Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea.
Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea.
Brain Sci. 2024 Feb 26;14(3):215. doi: 10.3390/brainsci14030215.
Toe grip strength has recently been suggested to play an essential role in maintaining balance and postural stability for ambulatory function in older populations. This study aimed to investigate its association with improving gait function three months after onset in patients with subacute stroke. This longitudinal cohort study included 98 first-ever stroke patients (67 ± 9 years, 56% female) within one month from the onset who could not ambulate independently. Functional outcome indicators, including toe grip strength, hand grip strength, knee extensor strength, Fugl-Meyer Assessment of Lower Extremity (FMA_LE), and the Postural Assessment Scale for Stroke (PASS), were assessed before and three months after the intervention. We analyzed the correlation between participants' gait function using a 10-meter walk test time and various functional indicators. Then, multiple linear regression analysis was used to investigate whether toe grip strength was related to the improvement of gait function. Correlation analysis revealed a significant positive correlation between the 10MWT time and toe grip strength ratio (affected/unaffected side), with a moderate effect size (r = -0.61, <0.001). Multiple regression analysis with covariates showed a significant relationship between 10MWT time and toe grip strength ratio (β = -0.113, < 0.001), FMA_LE (β = -1.315, = 0.004), PASS (β = -3.275, <0.001), and age (β = -0.159, = 0.004). In conclusion, toe grip strength was an essential factor associated with ambulatory function improvement in subacute stroke patients three months after onset. Additional toe grip muscle strengthening rehabilitation treatment can be expected to help improve the ambulatory function of subacute stroke patients in the future.
最近有人提出，脚趾握力在维持老年人群动态功能的平衡和姿势稳定性方面起着至关重要的作用。本研究旨在调查亚急性中风患者发病三个月后，脚趾握力与步态功能改善之间的关联。这项纵向队列研究纳入了98例首次发生中风的患者（年龄67±9岁，女性占56%），这些患者在发病后一个月内无法独立行走。在干预前和干预三个月后，对包括脚趾握力、手握力、膝关节伸肌力量、下肢Fugl-Meyer评估（FMA_LE）和中风姿势评估量表（PASS）在内的功能结局指标进行了评估。我们使用10米步行测试时间分析了参与者步态功能与各种功能指标之间的相关性。然后，采用多元线性回归分析来研究脚趾握力是否与步态功能的改善有关。相关性分析显示，10MWT时间与脚趾握力比值（患侧/健侧）之间存在显著正相关，效应量中等（r = -0.61，<0.001）。纳入协变量的多元回归分析显示，10MWT时间与脚趾握力比值（β = -0.113，< 0.001）、FMA_LE（β = -1.315，= 0.004）、PASS（β = -3.275，<0.001）和年龄（β = -0.159，= 0.004）之间存在显著关系。总之，脚趾握力是亚急性中风患者发病三个月后与动态功能改善相关的一个重要因素。预计额外的脚趾握力肌肉强化康复治疗未来有助于改善亚急性中风患者的动态功能。
