Paretic Propulsion and Trailing Limb Angle Are Key Determinants of Long-Distance Walking Function After Stroke.
Paretic Propulsion and Trailing Limb Angle Are Key Determinants of Long-Distance Walking Function After Stroke.
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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。
DOI：
10.1177/1545968314554625
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发表时间：
2015-07
影响因子：
4.2
通讯作者：
Reisman DS
中科院分区：
文献类型：
--
作者：
Awad LN;Binder-Macleod SA;Pohlig RT;Reisman DS
阐明通常针对的生物力学变量对卒中后长距离步行功能的相对重要性将有助于优化干预设计。目的：（1）确定三种生物力学结构变量对卒中后长距离步行的相对贡献;（2）确定训练后长距离步行功能改善的生物力学变化。44名中风后> 6个月的个体参与了这项研究。这些受试者的一个子集（n = 31）进行了12周的高强度运动训练。横截面（训练前）和纵向（训练后变化）回归量化了卒中后长距离步行功能（通过6分钟步行试验（6 MWT）测量）与步行生物力学之间的关系。生物力学变量被组织成站立相（麻痹推进和拖曳肢体角度），摆动相（麻痹踝关节背屈和膝关节屈曲），和对称性（步长和摆动时间）结构。训练前，所有变量与6 MWT距离相关（r = 0.39至0.75，p < 0.05）;然而，只有推进力（Prop）和拖曳肢体角度（TLA）独立预测6 MWT距离（R2 = 0.655，F（6，36）= 11.38，p <0.001）。有趣的是，只有ΔProp预测Δ 6 MWT;然而，训练前Prop，训练前TLA和ΔTLA调节了这种关系（调节模型R2 s分别为0.383，0.468，0.289）。瘫痪肢体在行走过程中产生推进力的能力是中风后长距离行走功能的关键决定因素。这一发现支持中风后干预措施的发展，影响推进力和拖曳肢体角度的缺陷。
Elucidation of the relative importance of commonly targeted biomechanical variables to poststroke long-distance walking function would facilitate optimal intervention design. To (1) determine the relative contribution of variables from three biomechanical constructs to poststroke long-distance walking and (2) identify the biomechanical changes underlying posttraining improvements in long-distance walking function. Forty-four individuals > 6 months after stroke participated in this study. A subset of these subjects (n = 31) underwent 12 weeks of high-intensity locomotor training. Cross-sectional (pretraining) and longitudinal (posttraining change) regression quantified the relationships between poststroke long-distance walking function, as measured via the 6-Minute Walk Test (6MWT), and walking biomechanics. Biomechanical variables were organized into stance phase (paretic propulsion and trailing limb angle), swing phase (paretic ankle dorsiflexion and knee flexion), and symmetry (step length and swing time) constructs. Pretraining, all variables correlated with 6MWT distance (r’s = 0.39 to 0.75, p’s < 0.05); however, only propulsion (Prop) and trailing limb angle (TLA) independently predicted 6MWT distance (R2 = 0.655, F(6,36) = 11.38, p < .001). Interestingly, only ΔProp predicted Δ6MWT; however, pretraining Prop, pretraining TLA, and ΔTLA moderated this relationship (moderation model R2s = 0.383, 0.468, 0.289, respectively). The paretic limb’s ability to generate propulsion during walking is a critical determinant of long-distance walking function after stroke. This finding supports the development of poststroke interventions that impact deficits in propulsion and trailing limb angle.
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影响因子：
1.8
作者：
Hall, A. L.;Bowden, M. G.;Neptune, R. R.
通讯作者：
Neptune, R. R.
影响因子：
8.3
作者：
Bowden, MG;Balasubramanian, CK;Kautz, SA
通讯作者：
Kautz, SA
影响因子：
1.8
作者：
Combs, Stephanie A.;Dugan, Eric L.;Curtis, Amy B.
通讯作者：
Curtis, Amy 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
影响因子：
4.2
作者：
Kautz SA;Bowden MG;Clark DJ;Neptune RR
通讯作者：
Neptune RR