von Schroeder H P, Coutts R D, Lyden P D, Billings E, Nickel V L
Department of Orthopaedics and Rehabilitation, University of California, San Diego 92103-1190, USA.
J Rehabil Res Dev. 1995 Feb;32(1):25-31.
Mechanical methods of quantifying gait are more sensitive to change than is direct clinical inspection. To assess gait parameters and patterns of patients with stroke, and the temporal changes of these parameters, a foot-switch gait analyzer was used to test 49 ambulatory patients with stroke and 24 controls. Patients walked significantly slower than controls, with decreased cadence, increased gait cycle, and increased time in double limb support. Patients' hemiplegic limbs spent more time in swing and stance when compared to controls; their unaffected limbs spent significantly more time in stance and single limb support compared to controls. Patients' hemiplegic side, when compared with the unaffected side, spent less time in stance and more time in swing. A flatfoot pattern was typically noted on the affected side. General gait parameters improved over time, with the largest changes occurring in the first 12 months. However, the percentage of time spent in double and single limb support, stance and swing, parameters which describe the asymmetrical pattern of gait, did not change over time. Abnormal gait was due to difficulty in moving the body over an unstable limb. Gait analysis can be of importance in documenting abnormalities and determining the effects of therapeutic modalities.
与直接的临床检查相比，量化步态的机械方法对变化更为敏感。为了评估中风患者的步态参数和模式以及这些参数随时间的变化，使用足部开关步态分析仪对49名能行走的中风患者和24名对照组进行了测试。患者行走速度明显慢于对照组，步频降低，步态周期延长，双下肢支撑时间增加。与对照组相比，患者偏瘫侧肢体在摆动期和支撑期花费的时间更多；与对照组相比，其非偏瘫侧肢体在支撑期和单下肢支撑期花费的时间明显更多。与非患侧相比，患者患侧在支撑期花费的时间更少，在摆动期花费的时间更多。患侧通常呈现扁平足模式。一般步态参数随时间有所改善，最大变化发生在最初的12个月。然而，双下肢和单下肢支撑、支撑期和摆动期所花费时间的百分比（这些参数描述了步态的不对称模式）并未随时间变化。异常步态是由于身体在不稳定肢体上移动困难所致。步态分析对于记录异常情况和确定治疗方式的效果可能具有重要意义。
