Speed-dependent biomechanical changes vary across individual gait metrics post-stroke relative to neurotypical adults.
Speed-dependent biomechanical changes vary across individual gait metrics post-stroke relative to neurotypical adults.
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相对于神经型成年人，速度依赖性的生物力学变化在中风后各个步态指标都有所不同。
DOI：
10.1186/s12984-023-01139-2
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发表时间：
2023-01-27
影响因子：
5.1
通讯作者：
Leech, Kristan A. A.
中科院分区：
文献类型：
--
作者：
Kettlety, Sarah A. A.;Finley, James M. M.;Reisman, Darcy S. S.;Schweighofer, Nicolas;Leech, Kristan A. A.
建议进行快速的步态训练，以减少中风后行走活动的限制。快速步行也可以减少中风后的步态运动损伤。然而，尚不清楚中风后的人和神经正常的成年人在以更快的速度行走时，步态运动学的差异是否会减少。为了确定更快的步行速度对中风后步态运动学的影响，相对于以相似速度行走的神经正常成年人。我们对28名中风后患者和50名神经正常的成年人在跑步机上以不同速度行走的数据进行了二次分析。我们评估了速度和群体对个体时空和运动学指标的影响，并在自选择和快速的速度下对所有指标进行k均值聚类。脑卒中后患者步长不对称性和后肢角度损伤减少，快速运动时组间差异减小。速度依赖性的峰值摆动、膝关节屈曲、髋部健行和颞部不对称的变化放大了组间差异。我们的聚类分析揭示了两个聚类。一个代表神经典型的步态行为，由神经典型和中风后参与者组成。另一个特征是中风步态行为——完全由中风后下肢Fugl-Meyer得分低于中风后神经典型步态行为集群的参与者组成。在两种速度下，簇的组成基本一致，并且簇之间的距离在高速下增加。脑卒中后快速行走的生物力学效应因个体步态指标而异。对于中风步态行为集群的参与者来说，与自我选择的速度相比，更快的步行导致的整体步态模式比神经正常的成年人更不同。这表明，为了增强以更快的速度行走的生物力学益处，并改善中风后的整体步态模式，在快速行走的背景下，可能需要专门针对具有较小速度依赖变化的步态指标。在线版本包含补充材料，可在10.1186/s12984-023-01139-2获得。
Gait training at fast speeds is recommended to reduce walking activity limitations post-stroke. Fast walking may also reduce gait kinematic impairments post-stroke. However, it is unknown if differences in gait kinematics between people post-stroke and neurotypical adults decrease when walking at faster speeds. To determine the effect of faster walking speeds on gait kinematics post-stroke relative to neurotypical adults walking at similar speeds. We performed a secondary analysis with data from 28 people post-stroke and 50 neurotypical adults treadmill walking at multiple speeds. We evaluated the effects of speed and group on individual spatiotemporal and kinematic metrics and performed k-means clustering with all metrics at self-selected and fast speeds. People post-stroke decreased step length asymmetry and trailing limb angle impairment, reducing between-group differences at fast speeds. Speed-dependent changes in peak swing knee flexion, hip hiking, and temporal asymmetries exaggerated between-group differences. Our clustering analyses revealed two clusters. One represented neurotypical gait behavior, composed of neurotypical and post-stroke participants. The other characterized stroke gait behavior—comprised entirely of participants post-stroke with smaller lower extremity Fugl-Meyer scores than the post-stroke participants in the neurotypical gait behavior cluster. Cluster composition was largely consistent at both speeds, and the distance between clusters increased at fast speeds. The biomechanical effect of fast walking post-stroke varied across individual gait metrics. For participants within the stroke gait behavior cluster, walking faster led to an overall gait pattern more different than neurotypical adults compared to the self-selected speed. This suggests that to potentiate the biomechanical benefits of walking at faster speeds and improve the overall gait pattern post-stroke, gait metrics with smaller speed-dependent changes may need to be specifically targeted within the context of fast walking. The online version contains supplementary material available at 10.1186/s12984-023-01139-2.
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paretic推进和尾肢角是中风后长距离步行功能的关键决定因素。
影响因子：
4.2
作者：
Awad LN;Binder-Macleod SA;Pohlig RT;Reisman DS
通讯作者：
Reisman DS
影响因子：
4.2
作者：
Awad LN;Palmer JA;Pohlig RT;Binder-Macleod SA;Reisman DS
通讯作者：
Reisman DS
影响因子：
2.4
作者：
Akbas, Tunc;Prajapati, Sunil;Sulzer, James
通讯作者：
Sulzer, James
影响因子：
2.4
作者：
Campanini, I.;Merlo, A.;Damiano, B.
通讯作者：
Damiano, B.
DOI：
10.1097/00004356-199109000-00010
发表时间：
1991-01-01
期刊：
International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation
影响因子：
--
作者：
Bohannon, R W;Horton, M G;Wikholm, J B
通讯作者：
Wikholm, J B