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上肢运动功能障碍对慢性脑卒中患者静态平衡的影响。

Influence of Impaired Upper Extremity Motor Function on Static Balance in People with Chronic Stroke.

机构信息

International Doctorate School, Rey Juan Carlos University, 28933 Madrid, Spain.

Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.

出版信息

Sensors (Basel). 2024 Jul 2;24(13):4311. doi: 10.3390/s24134311.

Abstract

BACKGROUND

Stroke is a leading cause of disability, especially due to an increased fall risk and postural instability. The objective of this study was to analyze the impact of motor impairment in the hemiparetic UE on static balance in standing, in subject with chronic stroke.

METHODS

Seventy adults with chronic stroke, capable of independent standing and walking, participated in this cross-sectional study. The exclusion criteria included vestibular, cerebellar, or posterior cord lesions. The participants were classified based on their UE impairment using the Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). A posturographic evaluation (mCTSIB) was performed in the standing position to analyze the center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) axes and its mean speed with eyes open (OE) and closed (EC) on stable and unstable surfaces.

RESULTS

A strong and significant correlation ( = -0.53; < 0.001) was observed between the mediolateral (ML) center of pressure (COP) oscillation and the FMA-UE, which was particularly strong with eyes closed [(EO) = 0.5; (EC) = 0.54]. The results of the multiple linear regression analysis indicated that the ML oscillation is influenced significantly by the FMA-Motor, and specifically by the sections on UE, wrist, coordination/speed, and sensation.

CONCLUSIONS

The hemiparetic UE motor capacity is strongly related to the ML COP oscillation during standing in individuals with chronic stroke, with a lower motor capacity associated with a greater instability. Understanding these relationships underpins the interventions to improve balance and reduce falls in people who have had a stroke.

摘要

背景

中风是导致残疾的主要原因,尤其是由于跌倒风险增加和姿势不稳定。本研究的目的是分析偏瘫上肢(UE)运动障碍对慢性中风患者站立静态平衡的影响。

方法

70 名具有独立站立和行走能力的慢性中风成人参与了这项横断面研究。排除标准包括前庭、小脑或后索病变。根据中风后上肢运动恢复评估(FMA-UE)对参与者的 UE 损伤进行分类。在站立位置进行动静态姿势平衡仪(mCTSIB)评估,以分析睁眼(OE)和闭眼(EC)时在前后(AP)和内外(ML)轴上的中心压力(COP)位移及其平均速度在稳定和不稳定表面上。

结果

在 ML 轴上的 COP 振荡和 FMA-UE 之间观察到强烈且显著的相关性(= -0.53;< 0.001),特别是闭眼时(EO = 0.5;EC = 0.54)。多元线性回归分析的结果表明,ML 振荡受 FMA-运动显著影响,特别是 UE、手腕、协调/速度和感觉部分。

结论

偏瘫上肢的运动能力与慢性中风患者站立时 ML COP 振荡密切相关,运动能力越低,不稳定性越大。了解这些关系为改善平衡和减少中风患者跌倒的干预措施提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3965/11244378/67ae2dd25106/sensors-24-04311-g001.jpg

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