Mio Kimito, Okamoto Takatsugu, Nakayama Yasuhide, Sakamoto Daigo, Yoshida Kentaro, Abo Masahiro
Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan.
Department of Rehabilitation, Nishi Hiroshima Rehabilitation Hospital, Hiroshima, Japan.
Medicine (Baltimore). 2025 Jul 4;104(27):e43137. doi: 10.1097/MD.0000000000043137.
In poststroke patients with hemiplegia, gait disorders often remain as a sequela. Although gait analysis commonly focuses on lower limb dysfunction, there is limited evidence addressing the contribution of upper limb movement to gait improvement after stroke. A 3D optical motion analysis is commonly used to treat gait disorders, as it allows precise assessment of gait disorders by measuring joint range of motion, stride length, and time. However, these require multiple cameras and sensors, making the setup time-consuming. In this case, we conducted gait analysis using a newly introduced and easier-to-use suit-type wearable device (STWD) before and after rehabilitation therapy in a chronic posthemorrhagic stroke patient.
An 82-year-old Japanese man with right hemiplegia and gait disorder due to left midbrain hemorrhage was referred to our hospital for rehabilitation therapy.
By using STWD, we determined that his gait disorder was mainly due to right upper limb hemiplegia, as STWD showed that the right shoulder flexion angle during gait was very limited.
We performed botulinum toxin type A therapy and repetitive transcranial magnetic stimulation for the upper limb, as well as physical and occupational therapy for upper limb and gait disorders.
Right shoulder flexion angle during gait, upper limb function assessed by Fugl-Meyer Assessment, and gait function assessed by Timed Up and Go test all improved. Each STWD session took about 2 to 3 minutes to set up.
When treating gait disorders, we should not only look at the patients' lower limb function but also their upper limb function as well. STWD is more convenient than the conventional 3-dimensional optical motion analysis, allowing for quick and less burdensome measurements. Its application in various scenarios is anticipated.
在中风后偏瘫患者中，步态障碍常常作为后遗症残留。尽管步态分析通常侧重于下肢功能障碍，但关于中风后上肢运动对步态改善的作用的证据有限。三维光学运动分析常用于治疗步态障碍，因为它可以通过测量关节活动范围、步长和时间来精确评估步态障碍。然而，这些方法需要多个摄像头和传感器，使得设置过程耗时。在这种情况下，我们在一名慢性出血性中风患者的康复治疗前后，使用一种新引入的、更易于使用的套装式可穿戴设备（STWD）进行了步态分析。
一名82岁的日本男性，因左中脑出血导致右侧偏瘫和步态障碍，被转诊至我院接受康复治疗。
通过使用STWD，我们确定他的步态障碍主要是由于右侧上肢偏瘫，因为STWD显示步态期间右肩屈曲角度非常有限。
我们对上肢进行了A型肉毒毒素治疗和重复经颅磁刺激，以及针对上肢和步态障碍的物理和职业治疗。
步态期间右肩屈曲角度、通过Fugl-Meyer评估法评估的上肢功能以及通过定时起立行走测试评估的步态功能均得到改善。每次STWD设置大约需要2至3分钟。
在治疗步态障碍时，我们不仅应关注患者的下肢功能，还应关注其上肢功能。STWD比传统的三维光学运动分析更方便，能够进行快速且负担较小的测量。预计其将在各种场景中得到应用。
