Fujii Ren, Tamari Makoto, Mizuta Naomichi, Hasui Naruhito, Nonaka Yuki
Department of Rehabilitation, Musashigaoka Hospital, Kumamoto, JPN.
Department of Physical Therapy, Reiwa Health Science University, Fukuoka, JPN.
Cureus. 2024 Dec 9;16(12):e75361. doi: 10.7759/cureus.75361. eCollection 2024 Dec.
Gait asymmetry in post-stroke patients is an important gait characteristic that is associated with their balance control, inefficiency, and risks of musculoskeletal injury to the non-paretic lower limb and falling. Unfortunately, most stroke patients retain an asymmetrical gait pattern, even though their gait independence and gait speed improve. We describe the clinical course of a subacute stroke patient who achieved a symmetrical gait at discharge after undergoing both gait training with orthoses and robot-assisted gait training from the early intervention phase. A Korean woman in her 50s developed a right frontal subcortical hemorrhage. She had severe left upper- and lower-extremity motor paralysis and was unable to walk independently. Her gait pattern was also observed to have a knee extension thrust pattern and a resulting asymmetric gait pattern. The gait interventions consisted of gait training with a knee-ankle-foot orthosis (KAFO) and an ankle-foot orthosis (AFO), in addition to robot-assisted gait training from the early onset. The control of the knee joint's movement was obtained by the attachment of the knee-ankle-foot robot to the paretic lower limb. Following these interventions, the patient was able to walk independently and had a symmetrical gait pattern at the time of discharge. The combination of robot-assisted gait training and gait training with orthoses for subacute stroke patients, as is widely used in general populations, may prevent the patients' mislearning of gait movements and contribute to the acquisition of a symmetrical gait pattern.
中风后患者的步态不对称是一种重要的步态特征，与他们的平衡控制、低效以及非瘫痪下肢的肌肉骨骼损伤风险和跌倒有关。不幸的是，大多数中风患者即使步态独立性和步态速度有所提高，仍保持不对称的步态模式。我们描述了一名亚急性中风患者的临床过程，该患者从早期干预阶段开始接受矫形器步态训练和机器人辅助步态训练后，出院时实现了对称步态。一名50多岁的韩国女性发生了右额叶皮质下出血。她患有严重的左上肢和下肢运动麻痹，无法独立行走。观察到她的步态模式存在膝关节伸展推力模式以及由此产生的不对称步态模式。步态干预包括使用膝踝足矫形器（KAFO）和踝足矫形器（AFO）进行步态训练，以及从发病早期就开始的机器人辅助步态训练。通过将膝踝足机器人连接到瘫痪的下肢来控制膝关节的运动。经过这些干预，患者能够独立行走，出院时步态模式对称。对于亚急性中风患者，将机器人辅助步态训练和矫形器步态训练相结合，就像在普通人群中广泛使用的那样，可能会防止患者步态运动的错误学习，并有助于获得对称的步态模式。
