中风后踝关节本体感觉与步态速度之间的弱关系：一项机器人评估研究。
The Weak Relationship Between Ankle Proprioception and Gait Speed After Stroke: A Robotic Assessment Study.
作者信息
Johnson Christopher A, Biswas Piyashi, Tapia Rubi, See Jill, Dodakian Lucy, Chan Vicky, Wang Po T, Nenadic Zoran, Do An H, Reinkensmeyer David J
机构信息
Henry Samueli School of Engineering Department of Biomedical Engineering, University of California, Irvine, CA, USA.
Department of Rehabilitation Services, University of California at Irvine Medical Center, Orange, USA.
出版信息
Neurorehabil Neural Repair. 2025 Sep 16:15459683251369497. doi: 10.1177/15459683251369497.
BACKGROUND
After stroke, ankle proprioceptive deficits are common and do not typically correlate with ankle weakness. Some studies report that these deficits correlate with gait function, supporting the importance of somatosensory input for gait control. Others have not found a relationship, possibly due to use of coarse proprioception measures. Robotic assessments of proprioception offer improved consistency and sensitivity.
OBJECTIVE
To establish relationships between ankle proprioception, gait function, and ankle motor in stroke survivors.
METHODS
We studied 39 individuals in the chronic phase of stroke using 2 robotic tests, Crisscross and Joint Position Reproduction (JPR), to quantify ankle proprioception. We examined associations of these measures with gait speed (10-meter walk test) and gait endurance (6-minute walk test). We also analyzed correlations with lower extremity motor impairment, including robotic measures of ankle strength (MVC) and active range of motion (AROM), and the lower extremity Fugl-Meyer exam (LEFM).
RESULTS
Impaired ankle proprioception was present in 87% of participants. Crisscross error weakly correlated with the 10mWT gait speed (ρ = -0.20, = 0.23) and 6MWT distance (ρ = -0.28, = .089). JPR error weakly correlated with 10mWT gait speed (ρ = -0.29, = .092) and significantly correlated with 6MWT distance (ρ = -0.34, = .04). No significant correlations were observed between ankle proprioceptive error and MVC, AROM, or LEFM ( > 0.2).
CONCLUSION
These results confirm the presence of a weak relationship between ankle proprioception and gait after stroke that is independent of several common measures of motor impairment.
背景
中风后，踝关节本体感觉缺陷很常见，且通常与踝关节无力无关。一些研究报告称，这些缺陷与步态功能相关，支持了体感输入对步态控制的重要性。其他研究则未发现这种关系，可能是由于使用了粗略的本体感觉测量方法。机器人对本体感觉的评估具有更高的一致性和敏感性。
目的
确定中风幸存者踝关节本体感觉、步态功能和踝关节运动之间的关系。
方法
我们使用两种机器人测试，即十字交叉测试和关节位置再现测试（JPR），对39名中风慢性期患者进行研究，以量化踝关节本体感觉。我们检查了这些测量值与步态速度（10米步行测试）和步态耐力（6分钟步行测试）之间的关联。我们还分析了与下肢运动障碍的相关性，包括踝关节力量（最大自主收缩，MVC）和主动活动范围（AROM）的机器人测量，以及下肢Fugl-Meyer评估（LEFM）。
结果
87%的参与者存在踝关节本体感觉受损。十字交叉测试误差与10米步行测试步态速度呈弱相关（ρ = -0.20，P = 0.23），与6分钟步行测试距离呈弱相关（ρ = -0.28，P = 0.089）。JPR误差与10米步行测试步态速度呈弱相关（ρ = -0.29，P = 0.092），与6分钟步行测试距离呈显著相关（ρ = -0.34，P = 0.04）。未观察到踝关节本体感觉误差与MVC、AROM或LEFM之间存在显著相关性（P > 0.2）。
结论
这些结果证实，中风后踝关节本体感觉与步态之间存在弱关系，且这种关系独立于几种常见的运动障碍测量指标。
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