Milczarek J J, Kirby R L, Harrison E R, MacLeod D A
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Arch Phys Med Rehabil. 1993 Mar;74(3):281-5.
We studied 14 patients to test the hypotheses that, when patients with hemiparesis use a cane to assist standing balance, their postural sway decreases and the average position of their center of pressure (COP) shifts forward and towards the cane side, and that there is no difference in either of these parameters between standard and four-footed canes. Each subject stood on a Kistler force platform for three ten-second intervals: one without a cane, one with a standard cane, and one with a four-footed cane. Matched-pairs t tests revealed a significant decrease in both the mediolateral (ML) and anteroposterior (AP) travel (postural sway) when the subjects used the standard cane. There was also a significant shift of the average ML position of the COP toward the cane side when they used a standard cane, but no significant difference in the average AP position. When they used the four-footed cane, neither the differences in travel nor the differences in COP position were significant, although they were similar in magnitude to those measured when they used the standard cane, compared with which there was no significant difference. Two conclusions appear warranted. First, a standard cane has a significant effect on force-platform measures of the standing balance of persons with hemiparesis of mild-to-moderate severity--specifically a reduction in the extent of ML and AP postural sway and a shift in the mean position of the COP toward the cane side. Second, as regards such measures of standing balance, a four-footed cane appears to offer no advantage over a standard one.
我们研究了14名患者，以检验以下假设：偏瘫患者使用手杖辅助站立平衡时，其姿势摆动会减小，压力中心（COP）的平均位置会向前并向手杖侧移动；并且标准手杖和四脚手杖在这些参数上均无差异。每位受试者站在奇石乐测力平台上，每次持续10秒，共进行三次：一次不使用手杖，一次使用标准手杖，一次使用四脚手杖。配对t检验显示，当受试者使用标准手杖时，其在内外侧（ML）和前后方向（AP）上的移动（姿势摆动）均显著减小。当他们使用标准手杖时，COP的平均ML位置也显著向手杖侧移动，但平均AP位置没有显著差异。当他们使用四脚手杖时，移动差异和COP位置差异均不显著，尽管其幅度与使用标准手杖时测得的相似，与标准手杖相比无显著差异。似乎可以得出两个结论。第一，标准手杖对轻度至中度偏瘫患者的站立平衡测力平台测量有显著影响——具体表现为ML和AP姿势摆动程度降低，以及COP平均位置向手杖侧移动。第二，就站立平衡的此类测量而言，四脚手杖似乎并不比标准手杖更具优势。
