Yang Chen, Veit Nicole, McKenzie Kelly, Aalla Shreya, Embry Kyle, Kishta Ameen, Roth Elliot, Jayaraman Arun
Shirley Ryan AbilityLab, Chicago, IL, United States.
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Front Physiol. 2024 Jul 24;15:1409304. doi: 10.3389/fphys.2024.1409304. eCollection 2024.
Post-stroke gait asymmetry leads to inefficient gait and a higher fall risk, often causing limited home and community ambulation. Two types of treadmills are typically used for training focused on symmetry: split-belt and single belt treadmills, but there is no consensus on which treadmill is superior to improve gait symmetry in individuals with stroke. To comprehensively determine which intervention is superior, we considered multiple spatial and temporal gait parameters (step length, stride time, swing time, and stance time) and their symmetries. Ten individuals with stroke underwent a single session of split-belt treadmill training and single belt treadmill training on separate days. The changes in step length, stride time, swing time, stance time and their respective symmetries were compared to investigate which training improves both spatiotemporal gait parameters and symmetries immediately after the intervention and after 5 min of rest. Both types of treadmill training immediately increased gait velocity (0.08 m/s faster) and shorter step length (4.15 cm longer). However, split-belt treadmill training was more effective at improving step length symmetry (improved by 27.3%) without sacrificing gait velocity or step length. However, this step length symmetry effect diminished after a 5-min rest period. Split-belt treadmill training may have some advantages over single belt treadmill training, when targeting step length symmetry. Future research should focus on comparing the long-term effects of these two types of training and examining the duration of the observed effects to provide clinically applicable information.
中风后的步态不对称会导致步态效率低下和跌倒风险增加，常常使患者在家中和社区的行走能力受限。通常使用两种类型的跑步机进行侧重于对称性的训练：分体式跑带跑步机和单跑带跑步机，但对于哪种跑步机在改善中风患者的步态对称性方面更具优势，目前尚无定论。为了全面确定哪种干预措施更具优势，我们考虑了多个空间和时间步态参数（步长、步幅时间、摆动时间和站立时间）及其对称性。十名中风患者在不同日期分别接受了一次分体式跑带跑步机训练和一次单跑带跑步机训练。比较步长、步幅时间、摆动时间、站立时间及其各自对称性的变化，以研究哪种训练在干预后及休息5分钟后能同时改善时空步态参数和对称性。两种类型的跑步机训练均能立即提高步态速度（快0.08米/秒）并缩短步长（长4.15厘米）。然而，分体式跑带跑步机训练在不牺牲步态速度或步长的情况下，在改善步长对称性方面更有效（提高了27.3%）。然而，经过5分钟的休息期后，这种步长对称性效果会减弱。在针对步长对称性方面，分体式跑带跑步机训练可能比单跑带跑步机训练具有一些优势。未来的研究应侧重于比较这两种训练的长期效果，并研究观察到的效果持续时间，以提供临床适用信息。
