中风幸存者中僵硬膝步态的识别。
Identification of stiff-knee gait in stroke survivors.
作者信息
Bacca Odair, Celestino Melissa Leandro, Barela José Angelo, Barela Ana Maria Forti
机构信息
Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil.
Escuela de Fisioterapia, Facultad de Salud, Universidad Industrial de Santander - UIS, Carrera 32 #29-31, Bucaramanga, Colombia.
出版信息
BMC Biomed Eng. 2025 Sep 1;7(1):11. doi: 10.1186/s42490-025-00097-1.
BACKGROUND
Stiff-knee gait is a common movement disorder in individuals with stroke; however, standardized criteria for its identification remain lacking. This study aimed to examine suitable criteria for identifying stiff-knee stroke survivors to facilitate comparisons across studies. Twenty-four stroke survivors (45.2±13.7 years old) and 24 age- and sex-matched controls (45.5±13.5 years old) with no known gait impairment participated in this study. Participants walked along a 10-m walkway at a self-selected comfortable speed. A motion capture system recorded the trajectories of retroreflective markers placed on specific body landmarks. The following knee flexion parameters during gait cycle were analyzed: (1) peak knee flexion during the swing period, (2) total range of motion (RoM cycle), calculated as the difference between maximum and minimum knee excursion during gait cycle, (3) RoM from toe-off to peak knee flexion ("RoM swing"), and (4) timing of peak flexion. Comparisons were made among control, paretic, and non-paretic limbs.
RESULTS
Among the 21 stroke survivors identified with stiff-knee gait, the paretic limb showed reduced peak swing, RoM swing, and RoM cycle compared to both the control and non-paretic limbs, as well as earlier timing compared to the non-paretic limb only.
CONCLUSIONS
Among the four examined criteria to identify stiff-knee gait in stroke survivors, the most suitable are peak knee flexion during the swing period of less than 40°, and knee range of motion from toe-off to peak knee flexion of less than 12°.
背景
膝关节僵硬步态是中风患者常见的运动障碍;然而,目前仍缺乏用于识别该症状的标准化标准。本研究旨在探讨用于识别膝关节僵硬的中风幸存者的合适标准,以促进不同研究之间的比较。24名中风幸存者(年龄45.2±13.7岁)和24名年龄及性别匹配、无已知步态障碍的对照者(年龄45.5±13.5岁)参与了本研究。参与者以自我选择的舒适速度沿着10米长的通道行走。运动捕捉系统记录了放置在特定身体标志点上的反光标记的轨迹。分析了步态周期中的以下膝关节屈曲参数:(1)摆动期的膝关节屈曲峰值,(2)运动总范围(RoM周期),计算方法为步态周期中膝关节最大和最小偏移量之差,(3)从足趾离地到膝关节屈曲峰值的RoM(“RoM摆动”),以及(4)屈曲峰值的时间。对对照组、患侧肢体和非患侧肢体进行了比较。
结果
在21名被确定为膝关节僵硬步态的中风幸存者中,患侧肢体与对照组和非患侧肢体相比,摆动峰值、RoM摆动和RoM周期均降低,且仅与非患侧肢体相比,屈曲时间更早。
结论
在用于识别中风幸存者膝关节僵硬步态的四个检查标准中,最合适的是摆动期膝关节屈曲峰值小于40°,以及从足趾离地到膝关节屈曲峰值的膝关节活动范围小于12°。