Nagai Koki, Amimoto Kazu, Ikeda Yumi
Department of Rehabilitation, Medical Corporation Sonodakai, Hanahata Rehabilitation Hospital, Tokyo, JPN.
Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, JPN.
Cureus. 2025 Apr 17;17(4):e82418. doi: 10.7759/cureus.82418. eCollection 2025 Apr.
Background and objective The righting reaction (RR) from a laterally tilted sitting position is influenced by trunk function and walking ability; however, its relationship with the severity of lower limb motor paralysis in persons with stroke remains unclear. If the characteristics of RR response patterns are clearly identified, they may aid in determining individualized physical therapy approaches. This study aimed to clarify RR patterns according to the severity of lower limb motor paralysis and to explore their potential implications for developing individualized rehabilitation strategies. Methods This cross-sectional study included 51 participants with stroke requiring significant assistance in activities of daily living at a Japanese convalescent hospital. Participants were categorized into Mild (n = 16), Moderate (n = 19), and Severe (n = 16) groups based on the severity of lower limb motor paralysis. Neck, trunk, and leg angles during RR were measured. One-way ANOVA with post-hoc tests was used for intergroup comparisons. Results Significant differences were found in the non-paralyzed leg angle during RR toward the paralyzed side (p = 0.0003) and neck angles in both directions (paralyzed side: p = 0.0164; non-paralyzed side: p = 0.0367). The non-paralyzed leg angle was larger in the Moderate group (Mild: -3.6±6.0°, Moderate: 5.5±8.5°, Severe: -2.9±5.2°; Mild-Moderate: 95% CI: 2.6-14.1, p = 0.0011; Moderate-Severe: 95% CI: 3.1-14.7, p = 0.0022). Neck angles were larger in the Severe group than those in the Mild group (non-paralyzed side: 95% CI: 0.6-11.8, p = 0.0241; paralyzed side: 95% CI: 0.3-10.7, p = 0.0333). Conclusions This study demonstrated that the severity of lower limb motor paralysis significantly influences RR movement patterns in stroke survivors. Understanding RR movement patterns based on paralysis severity may aid in developing targeted rehabilitation strategies to improve postural control and functional recovery.
背景与目的 从侧倾坐姿的翻正反应(RR)受躯干功能和行走能力影响;然而,其与中风患者下肢运动麻痹严重程度的关系仍不明确。如果能清楚识别RR反应模式的特征,可能有助于确定个性化的物理治疗方法。本研究旨在根据下肢运动麻痹的严重程度阐明RR模式,并探讨其对制定个性化康复策略的潜在意义。方法 这项横断面研究纳入了51名在日本康复医院日常生活活动需要大量协助的中风患者。根据下肢运动麻痹的严重程度,将参与者分为轻度(n = 16)、中度(n = 19)和重度(n = 16)组。测量RR过程中的颈部、躯干和腿部角度。采用单因素方差分析及事后检验进行组间比较。结果 在向麻痹侧的RR过程中,非麻痹侧腿部角度(p = 0.0003)以及两个方向的颈部角度(麻痹侧:p = 0.0164;非麻痹侧:p = 0.0367)存在显著差异。中度组的非麻痹侧腿部角度更大(轻度:-3.6±6.0°,中度:5.5±8.5°,重度:-2.9±5.2°;轻度-中度:95%可信区间:2.6-14.1,p = 0.0011;中度-重度:95%可信区间:3.1-14.7,p = 0.0022)。重度组的颈部角度大于轻度组(非麻痹侧:95%可信区间:0.6-11.8,p = 0.0241;麻痹侧:95%可信区间:0.3-10.7,p = 0.0333)。结论 本研究表明,下肢运动麻痹的严重程度显著影响中风幸存者的RR运动模式。基于麻痹严重程度了解RR运动模式可能有助于制定有针对性的康复策略,以改善姿势控制和功能恢复。