THE RELATION BETWEEN LIMB LOADING AND CONTROL PARAMETERS OF GAIT INITIATION IN PERSONS WITH STROKE
THE RELATION BETWEEN LIMB LOADING AND CONTROL PARAMETERS OF GAIT INITIATION IN PERSONS WITH STROKE
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DOI：
10.1016/s0003-9993(95)80631-8
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发表时间：
1995-07-01
影响因子：
4.3
通讯作者：
BEHRMAN, AL
中科院分区：
文献类型：
--
作者：
BRUNT, D;VANDERLINDEN, DW;BEHRMAN, AL
目的：本研究调查了中风后患者肢体负荷与步态启动的选定特征之间的关系。对象和环境： 13 名在康复诊所就诊的患者自愿参加这项研究。设计：为了描述临床特征，根据步态开始前站立期间相关肢体所分担的体重，将患者分为两组。主要结果指标：患者在力平台上用受累肢体或非受累肢体进行六次步态启动试验。使用峰值地面反作用力以及双侧胫骨前肌和腓肠肌肌电图（EMG）活动进行组间比较。结果：所有患者在步态开始时都表现出正确的垂直和内外方向的加载和卸载特征。在步态开始期间，初始肢体负载和地面反作用力之间存在很强的相关性（r = 0.79 至 0.95）。对于那些在开始步态之前表现出受累肢体负重减轻的患者，地面反作用力的变化显着较小（p < .001）。这些患者也无法用受影响的肢体产生向前的动力，如前后地面反作用力所证明的那样。对于所有患者，站立（非受累）肢体腓肠肌活动增加。这些数据进一步讨论了双侧肌电图活动与地面反作用力相互作用的关系。结论：这项研究表明，对称负重与提供在步态开始时产生向前动量的力的能力之间存在相关性。 (C) 1995 年由美国康复医学会和美国物理医学与康复学会
Objective: This study investigated the relation between limb loading and selected characteristics of gait initiation in patients after stroke. Subjects and Setting: Thirteen patients attending a rehabilitation clinic volunteered for the study. Design: For the description of clinical features, patients were divided into two groups dependent on the amount of body weight shared by the involved limb during stance before gait initiation. Main Outcome Measures: Patients performed six trials of gait initiation with either their involved or noninvolved limb on a force platform. Peak ground reaction forces and bilateral tibialis anterior and gastrocnemius electromyographic (EMG) activity were used for group comparison. Results: All patients showed the correct loading and unloading characteristics in the vertical and medial-lateral direction during gait initiation. Strong correlations were noted between initial limb loading and ground reaction forces during gait initiation (r = .79 to .95). Changes in ground reaction forces were significantly less (p < .001) for those patients who demonstrated decreased weight bearing on their involved limb before gait initiation. These patients were also unable to generate forward momentum, as evidenced by the fore-aft ground reaction force, with the involved limb. For all patients, increased gastrocnemius activity was noted in the stance (noninvolved) limb. The data are further discussed in regard to the relationship of the interaction of bilateral EMG activity and ground reaction forces. Conclusion: This study suggests that there is a correlation between symmetrical weight bearing and the ability to provide those forces that generate forward momentum in the initiation of gait. (C) 1995 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation