Mendes-Andrade Inês, Silva Miguel Reis E, Jacinto Jorge
Laboratório de Marcha, Centro de Medicina de Reabilitação de Alcoitão, 2649-506 Alcabideche, Portugal.
Neurol Int. 2025 Jan 18;17(1):10. doi: 10.3390/neurolint17010010.
BACKGROUND/OBJECTIVES: Post-stroke hemiparetic gait often presents with asymmetric patterns to compensate for stability deficits. This study examines gait differences in chronic stroke patients with spastic hemiparesis based on initial foot contact type-forefoot versus rearfoot.
Thirty-four independently walking spastic hemiparetic patients were retrospectively analyzed. Using 3D gait analysis, patients were categorized by initial contact type. Spatiotemporal descriptors, joint kinematics, kinetics, and EMG patterns were compared across groups.
Patients with rearfoot initial contact (G1) showed higher cadence, longer single-limb support time and shorter stride times than those with forefoot contact (G0). G1 patients also demonstrated greater knee flexion during stance, enhancing stability. Additionally, G1 patients with abnormal lateral gastrocnemius activation in the swing phase showed increased ankle power at the end of the stance phase.
In post-stroke spastic hemiparetic patients, the type of initial foot contact-forefoot or rearfoot-appears to influence gait characteristics, with rearfoot contact associated with a trend toward improved gait parameters, such as increased cadence and longer single-limb support.
背景/目的：中风后偏瘫步态常呈现不对称模式以代偿稳定性不足。本研究基于初始足接触类型（前足与后足），探讨慢性中风痉挛性偏瘫患者的步态差异。
对34例独立行走的痉挛性偏瘫患者进行回顾性分析。采用三维步态分析，根据初始接触类型对患者进行分类。比较各亚组间的时空参数、关节运动学、动力学和肌电图模式。
后足初始接触的患者（G1组）比前足接触的患者（G0组）具有更高的步频、更长的单支撑时间和更短的步幅时间。G1组患者在站立期还表现出更大的膝关节屈曲，增强了稳定性。此外，在摆动期外侧腓肠肌激活异常的G1组患者在站立期末期踝关节功率增加。
在中风后痉挛性偏瘫患者中，初始足接触类型（前足或后足）似乎会影响步态特征，后足接触与步态参数改善趋势相关，如步频增加和单支撑时间延长。
