Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
Movement Analysis Research Section, IRCCS Mondino Foundation, 27100 Pavia, Italy.
Sensors (Basel). 2024 Sep 17;24(18):6012. doi: 10.3390/s24186012.
: Stroke-induced immunosuppression (SII) represents a negative rehabilitative prognostic factor associated with poor motor performance at discharge from a neurorehabilitation unit (NRB). This study aims to evaluate the association between SII and gait impairment at NRB admission. : Forty-six stroke patients (65.4 ± 15.8 years, 28 males) and 42 healthy subjects (HS), matched for age, sex, and gait speed, underwent gait analysis using an inertial measurement unit at the lumbar level. Stroke patients were divided into two groups: (i) the SII group was defined using a neutrophil-to-lymphocyte ratio ≥ 5, and (ii) the immunocompetent (IC) group. Harmonic ratio (HR) and short-term largest Lyapunov's exponent (sLLE) were calculated as measures of gait symmetry and stability, respectively. : Out of 46 patients, 14 (30.4%) had SII. HR was higher in HS when compared to SII and IC groups ( < 0.01). HR values were lower in SII when compared to IC subjects ( < 0.01). sLLE was lower in HS when compared to SII and IC groups in the vertical and medio-lateral planes ( ≤ 0.01 for all comparisons). sLLE in the medio-lateral plane was higher in SII when compared to IC subjects ( = 0.04). : SII individuals are characterized by a pronounced asymmetric gait and a more impaired dynamic gait stability. Our findings underline the importance of devising tailored rehabilitation programs in patients with SII. Further studies are needed to assess the long-term outcomes and the role of other clinical features on gait pattern.
卒中诱导的免疫抑制(SII)是神经康复病房(NRB)出院时运动功能不良的负性康复预后因素。本研究旨在评估 SII 与 NRB 入院时步态障碍的相关性。
46 例卒中患者(65.4±15.8 岁,28 名男性)和 42 名健康对照者(HS),年龄、性别和步速匹配,在腰椎水平使用惯性测量单元进行步态分析。将卒中患者分为两组:(i)SII 组定义为中性粒细胞与淋巴细胞比值≥5,(ii)免疫功能正常(IC)组。分别采用谐波比(HR)和短期最大 Lyapunov 指数(sLLE)作为步态对称性和稳定性的测量指标。
在 46 例患者中,14 例(30.4%)存在 SII。与 HS 相比,SII 和 IC 组的 HR 更高(<0.01)。与 IC 组相比,SII 组的 HR 值更低(<0.01)。与 HS 相比,SII 和 IC 组在垂直和横向平面的 sLLE 更低(所有比较均<0.01)。与 IC 组相比,SII 组在横向平面的 sLLE 更高(=0.04)。
SII 患者的特点是明显的不对称步态和更受损的动态步态稳定性。我们的研究结果强调了为 SII 患者制定个性化康复方案的重要性。需要进一步研究来评估长期结果以及其他临床特征对步态模式的作用。