Differences in causes of stiff knee gait in knee extensor activity or ankle kinematics: A cross-sectional study
Differences in causes of stiff knee gait in knee extensor activity or ankle kinematics: A cross-sectional study
复制标题
膝关节伸肌活动或踝关节运动学中膝关节僵硬步态原因的差异：一项横断面研究
DOI：
10.1016/j.gaitpost.2022.09.078
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Kobayashi Yasutaka
中科院分区：
文献类型：
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作者：
Fujita Kazuki;Tsushima Yuichi;Hayashi Koji;Kawabata Kaori;Sato Mamiko;Kobayashi Yasutaka
研究背景膝关节僵硬步态（SKG）是脑卒中后常见的一种步态，是由于摆动期股直肌过度活动所致。SKG的另一个原因是偏瘫步态的蹬离无力。先前的研究没有考虑膝伸肌的幅度在他们的subjects.Research QuestionsSKG的原因不同患者之间的高和低的膝伸肌活动在摆动阶段的效果？方法对38例慢性脑卒中偏瘫患者进行SKG检查。在放置惯性传感器和肌电图后，患者以舒适的速度行走10米。所有患者均根据主成分2（PC 2）的符号进行分类，主成分2（PC 2）是从瘫痪肢体早期摆动阶段的肌电振幅中获得的膝伸肌大因子负荷的成分。然后，膝关节屈曲的运动学参数和其他步态参数在各组进行了比较，并进行了相关性analysis.ResultsIn高PC 2组，在摆动阶段的峰值膝关节屈曲的时间早，股外侧肌活动在preswing阶段与膝关节屈曲角度在摆动阶段呈负相关。在低PC 2组中，踝关节跖屈角速度在脚趾离地是缓慢的，这与膝关节屈曲角度在摆动phase.SignificanceThe SKG的原因可能是一个不适当的活动股外侧肌，而不是股直肌在高膝伸肌活动和脚趾离地缓慢的跖屈速度在低膝伸肌活动的患者。偏瘫患者发生SKG的原因并不都是常见的，根据痉挛性膝伸肌活动的个体性需要不同的治疗策略。
BackgroundStiff knee gait (SKG), a common occurrence after the onset of stroke, is caused by hyperactivity of the rectus femoris during the swing phase. Another cause of SKG is the weakness of push-off in hemiparetic gait. Prior research did not consider the effect of the magnitude of knee extensors in their subjects.Research questionDoes the cause of SKG differ between patients with high and low knee extensor activities during the swing phase?MethodsWe examined 38 patients with chronic stroke hemiplegia who presented with SKG. After placing an inertia sensor and an electromyogram, patients walked 10 m at a comfortable speed. All patients were categorized per the sign of the principal component 2 (PC2) as a component with large factor loadings of knee extensors attained from the electromyographic amplitude during the early swing phase of the paretic limb. Then, the kinematic parameters of knee flexion and other gait parameters in each group were compared, and a correlation analysis was performed.ResultsIn the high PC2 group, the timing of peak knee flexion during the swing phase was early, and vastus lateralis activity during the preswing phase negatively correlated with the knee-flexion angle during the swing phase. In the low PC2 group, the angular velocity of ankle plantar flexion at the toe-off was slow, which positively correlated with the knee-flexion angle during the swing phase.SignificanceThe cause of SKG could be an inappropriate activity of the vastus lateralis rather than the rectus femoris in patients with high knee extensor activity and slow plantar-flexion velocity at toe-off in patients with low knee extensor activity. Not all causes of SKG in patients with hemiplegia are common, and different treatment strategies are needed per the individuality of spastic knee extensor activity.