Li Congjun, Ye Chen, Sun Rui, Pan Ruosu, Jiang Shuai, Yan Yuyign, Yang Tang, Cao Le, Wang Hang, Wang Youjie, Liu Junfeng, Tao Wendan, Wu Bo
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, China.
Brain Behav. 2025 May;15(5):e70582. doi: 10.1002/brb3.70582.
Thalamic infarction (TI) can lead to gait disturbances (GDs), even in the absence of significant motor impairments. Understanding the characteristics of GDs in TI patients is crucial for developing targeted rehabilitation strategies. Nonetheless, very little is known about the detailed gait changes in TI patients. This study aimed to investigate and characterize these parameters in TI patients.
Ninety participants, including 45 subacute TI patients and 45 age-sex-matched healthy controls, were cross-sectionally and consecutively included from West China Hospital, Sichuan University. A detailed set of spatiotemporal gait analyses was performed with forty-one parameters as output, evaluated using the "ReadyGo" three-dimensional motion balance testing system. Additionally, we analyzed the correlation between cerebral small vessel disease (CSVD) and gait parameters in TI and healthy controls (HC) and performed a Fisher z-test to determine whether there was a significant difference.
Variability, stride length, stride speed, and swing velocity significantly differed in the affected and unaffected sides of TI patients. TI patients exhibited differences in thirty-eight gait parameters compared to controls. Coordination analysis revealed impairments in the timed up and go test, with longer total time, turn time, stand-up time, and reduced stride speed. Additionally, deficits were noted in the Heel-Knee-Shin test and Finger-Nose test. However, no differences were found in Romberg's test. Balance assessment showed variations in sit time, torso rocking degree, torso forward roll degree, and walking speed. The correlation between gait parameters and CSVD in TI and HC is presented. Additionally, it was found that total burden leads to a decrease in step width in TI patients and increases trunk sway degree in the tandem stance test in TI.
This study demonstrates distinct spatiotemporal gait impairment patterns, coordination, and balance deficits in TI patients. Additionally, our findings suggest that the mechanisms underlying GDs may differ between TI patients and HC in relation to CSVD. These findings emphasize the need for personalized rehabilitation strategies to target these specific GDs in TI patients.
丘脑梗死（TI）即使在没有明显运动障碍的情况下也可导致步态障碍（GDs）。了解TI患者步态障碍的特征对于制定有针对性的康复策略至关重要。然而，对于TI患者详细的步态变化知之甚少。本研究旨在调查和描述TI患者的这些参数。
从四川大学华西医院横断面连续纳入90名参与者，包括45名亚急性TI患者和45名年龄、性别匹配的健康对照。使用“ReadyGo”三维运动平衡测试系统进行了一组详细的时空步态分析，以41个参数作为输出进行评估。此外，我们分析了TI患者和健康对照（HC）中脑小血管疾病（CSVD）与步态参数之间的相关性，并进行了Fisher z检验以确定是否存在显著差异。
TI患者患侧和未患侧的变异性、步长、步速和摆动速度存在显著差异。与对照组相比，TI患者在38个步态参数上表现出差异。协调性分析显示定时起立行走测试存在障碍，总时间、转身时间、站立时间更长，步速降低。此外，在跟膝胫试验和指鼻试验中也发现了缺陷。然而，在闭目直立试验中未发现差异。平衡评估显示坐立时间、躯干摇摆程度、躯干前滚程度和步行速度存在变化。呈现了TI患者和HC中步态参数与CSVD之间的相关性。此外，还发现总负担导致TI患者步宽减小，在TI患者的串联站立试验中躯干摇摆程度增加。
本研究证明了TI患者存在独特的时空步态障碍模式、协调性和平衡缺陷。此外，我们的研究结果表明，TI患者和HC在与CSVD相关的GDs潜在机制可能不同。这些发现强调了针对TI患者这些特定GDs制定个性化康复策略的必要性。
