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脑卒中患者在舒适和快速速度下行走时推进力和后期制动力的变化模式。

Patterns of change in propulsion force and late braking force in patients with stroke walking at comfortable and fast speeds.

机构信息

Department of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka, Japan.

Graduate Department of Human Environment Design, Faculty of Human Life Design, Toyo University, Tokyo, Japan.

出版信息

Sci Rep. 2024 Sep 27;14(1):22316. doi: 10.1038/s41598-024-74093-1.

Abstract

Increased propulsion force (PF) in the paretic limb is associated with improved walking speed in patients with stroke. However, late braking force (LBF), an additional braking force occurring between PF onset and toe-off, is present in a subset of stroke patients. Few studies have investigated the changes in LBF and walking speed in these patients. This study aimed to elucidate the patterns of change in PF and LBF during fast gait in hemiplegics and identify potential compensatory strategies based on the LBF patterns. Data from 100 patients with stroke walking at both comfortable (mean, 0.79 ± 024 m/s) and fast speeds (mean, 1.06 ± 0.35 m/s) were analyzed retrospectively stroke using a 3D motion analyzer. PF was higher during fast-speed walking than that during comfortable-speed walking in all patients, while LBF showed both decreasing and increasing trends during fast-speed walking. In the LBF increasing pattern, a reduction in in-phase coordination of the shank and foot during the pre-swing phase was observed, along with an increase in pelvic hike during fast-speed walking compared to those in the decreasing LBF pattern. Our findings demonstrate that alterations in LBF patterns are associated with gait deviations in patients with stroke at fast speeds.

摘要

在脑卒中患者中,瘫痪肢体的推进力(PF)增加与步行速度的提高相关。然而,在一部分脑卒中患者中存在着晚期制动力(LBF),这是一种在 PF 起始和足离地之间出现的额外制动力。很少有研究调查过这些患者的 LBF 和步行速度的变化。本研究旨在阐明偏瘫患者快速行走时 PF 和 LBF 的变化模式,并根据 LBF 模式确定潜在的代偿策略。使用三维运动分析仪对 100 名脑卒中患者在舒适速度(平均 0.79±024 m/s)和快速速度(平均 1.06±0.35 m/s)下行走时的数据进行了回顾性分析。所有患者在快速行走时的 PF 均高于舒适速度行走时的 PF,而 LBF 在快速行走时则呈现出下降和上升的趋势。在 LBF 上升模式中,与 LBF 下降模式相比,在预摆阶段观察到小腿和足部的同相协调减少,同时在快速行走时骨盆抬高增加。我们的研究结果表明,在快速行走时,LBF 模式的改变与脑卒中患者的步态偏差有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8993/11436743/a47c2cb8c9a9/41598_2024_74093_Fig1_HTML.jpg

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