APHP, GHU Paris-Saclay, Raymond Poincaré Hospital, Physical Medicine and Rehabilitation Department, 92380 Garches, France.
IFMK Saint-Michel, 75015 Paris, France.
Sensors (Basel). 2024 Jun 29;24(13):4241. doi: 10.3390/s24134241.
Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.
运动和平衡障碍是偏瘫患者的主要限制因素。计时起立行走测试（TUG）是一项复杂的导航任务，涉及定向行走和障碍物回避。我们假设偏瘫患者在复杂的运动任务中会采取谨慎的步态。主要目的是比较 TUG（前进、转弯、返回）的运动亚任务和直线行走之间的时空步态参数和谨慎步态指标。我们的次要目的是分析 TUG 表现与平衡测量之间的关系，比较跌倒者和非跌倒者之间的时空步态参数，并确定 TUG 表现的生物力学决定因素。使用运动捕捉系统分析 TUG 和直线行走期间的生物力学参数。进行了重复测量方差分析和两步升序多元回归（包括性能变量和生物力学变量）。与前进和返回以及直线行走相比，29 名参与者在转弯时的步速、步长和单侧支撑阶段（SSP）百分比降低，而步宽和双侧支撑阶段百分比增加。TUG 表现与几项平衡测量有关。转弯表现（R = 63%）和转弯轨迹偏差以及前进时患侧和垂直质心速度的 SSP 百分比（R = 71%）决定了 TUG 表现时间。偏瘫患者在复杂导航中采取谨慎的步态，以牺牲表现为代价。
