Visintin M, Barbeau H
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Paraplegia. 1994 Aug;32(8):540-53. doi: 10.1038/sc.1994.86.
The effects of walking with and without parallel bars, providing 40% body weight support (BWS) and increasing speed on the gait pattern of spastic paretic subjects during treadmill locomotion were investigated. In asymmetrically involved subjects, walking without parallel bars led to a more symmetrical gait pattern with decreased compensation of the less involved side. This was accompanied by changes in electromyographic (EMG) and sagittal angular displacement profiles which favoured a more normal swing phase of the more involved limb. When symmetrically involved subjects walked without parallel bars, increases in EMG activity, with prolonged activation during the stance phase were noted, especially in the distal muscles. Providing 40% BWS facilitated gait when walking without parallel bars especially in the asymmetrically or severely involved subjects who showed marked difficulty at 0% BWS. Forty percent BWS led to a decrease in clonus associated with walking without parallel bars. Higher treadmill speeds increased clonus in some subjects while in others it only caused a small increase in EMG amplitude. Implications for gait training are discussed.
研究了在跑步机行走过程中，有、无双杠辅助，提供40%体重支持（BWS）以及增加速度对痉挛性偏瘫患者步态模式的影响。在非对称性受累患者中，无双杠辅助行走会导致步态模式更对称，患侧代偿减少。这伴随着肌电图（EMG）和矢状角位移曲线的变化，有利于患侧肢体更正常的摆动期。当对称性受累患者无双杠辅助行走时，观察到EMG活动增加，尤其是在站立期激活时间延长，特别是在远端肌肉。在无双杠辅助行走时，提供40%BWS有助于改善步态，尤其是在非对称性或严重受累患者中，这些患者在0%BWS时表现出明显困难。40%BWS导致与无双杠辅助行走相关的阵挛减少。更高的跑步机速度在一些患者中增加了阵挛，而在另一些患者中仅导致EMG幅度小幅增加。文中讨论了对步态训练的意义。
