Colborne G R, Olney S J, Griffin M P
Department of Anatomy, Queen's University, Kingston, Ontario, Canada.
Arch Phys Med Rehabil. 1993 Oct;74(10):1100-6. doi: 10.1016/0003-9993(93)90069-m.
A computer-assisted feedback system was developed to present to walking subjects instantaneous feedback of their muscle activity or joint angular excursions during gait. Targets for muscle activity or joint motion were displayed on the feedback screen along with timing cues that prompted muscle activity or joint flexion/extension at specific times during the gait cycle. The purpose was to compare the effectiveness of joint angle and electromyographic (EMG) feedback to a focused program of physical therapy for gait. Eight hemiplegic stroke patients were treated with ankle joint angle feedback, EMG biofeedback from the soleus muscle, and conventional physical therapy for gait in a three-period crossover design. PT was given either first or last in the sequence of treatments. Gait analysis prior to and following each type of treatment revealed that the feedback treatments resulted in significant increases in stride length and walking velocity and in positive changes in push-off impulse, gait symmetry, and standing weight-bearing symmetry, as evaluated in a general linear model and paired t-tests. Overall, physical therapy produced no significant changes. However, when physical therapy was the first treatment of the sequence, significant increases in stride length and velocity were observed. When physical therapy was last, there were significant negative changes in gait symmetry and standing weight-bearing symmetry, and negative trends in stride length, walking velocity, and push-off impulse. It is concluded that computer-assisted feedback is an effective tool for retraining gait in stroke patients.
开发了一种计算机辅助反馈系统，用于向行走的受试者呈现其步态期间肌肉活动或关节角偏移的即时反馈。肌肉活动或关节运动的目标与时间提示一起显示在反馈屏幕上，这些时间提示在步态周期的特定时间促使肌肉活动或关节屈伸。目的是比较关节角度和肌电图（EMG）反馈与针对步态的重点物理治疗计划的有效性。八名偏瘫中风患者在三阶段交叉设计中接受了踝关节角度反馈、比目鱼肌的肌电生物反馈以及针对步态的传统物理治疗。物理治疗在治疗顺序中要么排在第一位，要么排在最后一位。在每种治疗之前和之后进行的步态分析表明，在一般线性模型和配对t检验中评估，反馈治疗导致步幅长度和步行速度显著增加，以及蹬离冲量、步态对称性和站立负重对称性的积极变化。总体而言，物理治疗没有产生显著变化。然而，当物理治疗是序列中的第一种治疗时，观察到步幅长度和速度显著增加。当物理治疗排在最后时，步态对称性和站立负重对称性出现显著负变化，步幅长度、步行速度和蹬离冲量出现负趋势。得出的结论是，计算机辅助反馈是中风患者步态再训练的有效工具。
