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通过运动学分析评估中风患者的步行功能:一项系统综述。

Assessment of ambulation functions through kinematic analysis in individuals with stroke: a systematic review.

作者信息

Li Jiaqi, Kwong Patrick W, Lin Wang, Fong Kenneth N, Wu Wenping, Sidarta Ananda

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.

Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.

出版信息

Eur J Phys Rehabil Med. 2025 Feb;61(1):28-40. doi: 10.23736/S1973-9087.25.08767-2.

Abstract

INTRODUCTION

Although kinematic assessments for stroke-induced lower limb impairments offer a promising alternative to conventional scale evaluations, interpreting high-dimensional kinematic data remains challenging due to numerous metrics reported in past studies. This study aimed to provide an exhaustive overview of existing studies using kinematics data to assess the gait impairments in individuals with stroke, along with examining their clinimetric properties for future clinical applications.

EVIDENCE ACQUISITION

A systematic search was conducted across PubMed (08/2024), Scopus (08/2024), Web of Science (08/2024), CINAHL (08/2024), EMBASE (08/2024), and IEEE (08/2024). We included articles that recruited individuals over 18 years old with stroke and utilized motion capture technologies to evaluate lower limb kinematics. Similar metrics were consolidated in the analysis, and the COSMIN Risk of Bias Checklist was used to evaluate the methodological quality of studies investigating the clinimetric properties of kinematic metrics. Convergent validity of metrics was evaluated by examining their association with the Fugl-Meyer scale of lower limbs and walking speed. Moreover, the GRADE approach was used to rate the quality of evidence.

EVIDENCE SYNTHESIS

A total of 383 studies were classified into 10 categories. Seven studies on metric reliability were rated high for methodological quality. Metrics with satisfactory reliability included spatiotemporal, spatial metrics, and a data-driven score. Six studies with high methodological quality assessed convergent validity. The dynamic gait index, angular component of the coefficient of correspondence (ACC), change in cadence, stride length, and hip range of motion showed satisfactory validity. Among the 13 studies, 12 studies were rated as moderate quality of evidence using the GRADE approach.

CONCLUSIONS

There are significant variations in measurements across studies, and high-quality studies evaluating clinimetric properties are scarce. For a more standardized evidence-based approach to kinematic lower limb assessment, further high-quality research validating these assessments' clinimetric properties is essential.

摘要

引言

尽管针对中风引起的下肢功能障碍的运动学评估为传统的量表评估提供了一种有前景的替代方法,但由于过去研究中报告的众多指标,解释高维运动学数据仍然具有挑战性。本研究旨在全面概述现有利用运动学数据评估中风患者步态障碍的研究,并检查其临床测量属性以供未来临床应用。

证据获取

在PubMed(2024年8月)、Scopus(2024年8月)、科学网(2024年8月)、CINAHL(2024年8月)、EMBASE(2024年8月)和IEEE(2024年8月)上进行了系统检索。我们纳入了招募18岁以上中风患者并利用运动捕捉技术评估下肢运动学的文章。分析中合并了相似的指标,并使用COSMIN偏倚风险清单来评估研究运动学指标临床测量属性的研究的方法学质量。通过检查指标与下肢Fugl-Meyer量表和步行速度的关联来评估指标的收敛效度。此外,采用GRADE方法对证据质量进行评级。

证据综合

总共383项研究被分为10类。七项关于指标可靠性的研究在方法学质量方面被评为高等级。可靠性令人满意的指标包括时空指标、空间指标和一个数据驱动得分。六项方法学质量高的研究评估了收敛效度。动态步态指数、对应系数(ACC)的角度成分、步频变化、步长和髋关节活动范围显示出令人满意的效度。在这13项研究中,12项研究使用GRADE方法被评为中等证据质量。

结论

各研究之间的测量存在显著差异,评估临床测量属性的高质量研究稀缺。为了采用更标准化的基于证据的方法进行下肢运动学评估,进一步开展验证这些评估临床测量属性的高质量研究至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1310/11920755/c7e1d3b72404/8767-f1.jpg

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