Gait asymmetry pattern following stroke determines acute response to locomotor task.
Gait asymmetry pattern following stroke determines acute response to locomotor task.
复制标题
DOI：
10.1016/j.gaitpost.2020.02.016
复制
发表时间：
2020-03
期刊：
影响因子：
2.4
通讯作者：
Patten C
中科院分区：
文献类型：
--
作者：
Little VL;Perry LA;Mercado MWV;Kautz SA;Patten C
鉴于中风后步态功能障碍的普遍存在，步行恢复是康复的主要目标。然而，目前的步态康复方法并没有显示出一致的益处。步态不对称在恢复行走能力的中风幸存者中很常见，与步行能量成本增加有关，是中风后跌倒的重要预测因素。此外，步态不对称的不同模式可能会对步态训练参数做出不同的反应。本研究的目的是确定在地面行走过程中观察到的步长不对称模式(对称、NPShort、PShort)是否存在对运动任务条件的不同反应。参与者首先以他们自己选择的步行速度走到地面上。将地面数据与跑步机步行时测试的三种任务条件进行比较：自选速度(TM)，自选速度(BWS)，自选速度(BWS)，最舒适速度(GuidanceNP)，30%体重支撑和非瘫痪腿部指导(GuidanceNP)。我们的主要测量指标是：步长、步长和单肢支撑持续时间的对称性指数。我们确定了每个步长不对称亚组对运动任务条件的反应的差异。引导性NP仅在NPort组中诱导出强烈的空间对称性，而在对称性组和PShort组中诱导出时间对称性。重要的是，我们发现TM和BWS条件不足以影响空间或时间步态对称性。与运动训练一致的任务条件不会在步态不对称的子模式中产生一致的效果。我们发现具有不同不对称模式的组对运动任务条件的反应不同，这表明这些亚组可能需要独特的干预策略。尽管两组在不对称特征上存在差异，但在每组中注意到的对称性改善都是由偏瘫和非偏瘫肢体的变化驱动的。
Given the prevalence of gait dysfunction following stroke, walking recovery is a primary goal of rehabilitation. However, current gait rehabilitation approaches fail to demonstrate consistent benefits. Gait asymmetry, prevalent among stroke survivors who regain the ability to walk, is associated with an increased energy cost of walking and is a significant predictor of falls post-stroke. Furthermore, differential patterns of gait asymmetry may respond differently to gait training parameters. The purpose of this study was to determine whether differential responses to locomotor task condition occur on the basis of step length asymmetry pattern (Symmetrical, NPshort, Pshort) observed during overground walking. Participants first walked overground at their self-selected walking speed. Overground data were compared against three task conditions all tested during treadmill walking: self-selected speed with 0% body weight support (TM); self-selected speed with 30% body weight support (BWS); and fastest comfortable speed with 30% body weight support and nonparetic leg guidance (GuidanceNP). Our primary metrics were: symmetry indices of step length, stride length, and single limb support duration. We identified differences in the response to locomotor task conditions for each step length asymmetry subgroup. GuidanceNP induced an acute spatial symmetry only in the NPshort group and temporal symmetry in the Symmetrical and Pshort groups. Importantly, we found the TM and BWS conditions were insufficient to impact either spatial or temporal gait symmetry. Task conditions consistent with locomotor training do not produce uniform effects across subpatterns of gait asymmetry. We identified differential responses to locomotor task conditions between groups with distinct asymmetry patterns, suggesting these subgroups may require unique intervention strategies. Despite group differences in asymmetry characteristics, improvements in symmetry noted in each group were driven by changes in both the paretic and nonparetic limbs.
登录
查看更多内容
DOI：
10.1016/j.apmr.2007.08.109
发表时间：
2007-11-01
影响因子：
4.3
作者：
Jonsdottir, Johanna;Cattaneo, Davide
通讯作者：
Cattaneo, Davide
DOI：
10.1016/s0003-9993(95)80038-7
发表时间：
1995-01-01
影响因子：
4.3
作者：
JORGENSEN, HS;NAKAYAMA, H;OLSEN, TS
通讯作者：
OLSEN, TS
影响因子：
4.2
作者：
Bowden, Mark G.;Balasubramanian, Chitralakshmi K.;Kautz, Steven A.
通讯作者：
Kautz, Steven A.
影响因子：
2.5
作者：
Kautz, SA;Patten, C
通讯作者：
Patten, C
影响因子：
2.4
作者：
Patterson, Kara K.;Gage, William H.;McIlroy, William E.
通讯作者：
McIlroy, William E.