Can prior exposure to repeated non-paretic slips improve reactive responses on novel paretic slips among people with chronic stroke?
Can prior exposure to repeated non-paretic slips improve reactive responses on novel paretic slips among people with chronic stroke?
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DOI：
10.1007/s00221-021-06300-8
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发表时间：
2022-04
影响因子：
2
通讯作者：
Bhatt, Tanvi
中科院分区：
文献类型：
--
作者：
Dusane, Shamali;Bhatt, Tanvi
本研究探讨了慢性中风（PWCS）患者是否可以适应非轻瘫地上步态滑倒，以及这种事先暴露于非轻瘫滑倒是否可以改善对新的轻瘫滑倒的反应。49名PwCS被随机分配到适应组或对照组，适应组接受8次意外的、地上的、非paratic-side步态滑动，然后接受2次paratic-side滑动，对照组接受2次paratic-side滑动。分析了打滑结果、恢复策略、质心状态稳定性、打滑后步长和打滑运动学。适应组从第一次到第八次非麻痹性滑倒表现出跌倒减少，沿着稳定性、步幅和滑倒运动学改善（p < 0.05）。在适应组中，在比较新的滑动时，腹膜侧表现出相当的滑动前稳定性（p > 0.05）;然而，观察到滑动后稳定性较低，滑动速度增加和福尔斯跌倒（p < 0.05）。新型麻痹性适应性滑脱组与对照组比较，各项指标均无显著性差异（P > 0.01）。然而，在第二次滑动时有快速改善，使得适应组从第一次到第二次麻痹性滑动的表现与对照组相比有所改善（p < 0.01）。PWCS表现出即时的主动和被动适应地上，nonparetic侧步态滑动。然而，PWCS没有表现出任何肢体间的性能增益的paratic-side之前nonparatic-side适应时，暴露于一个新的paratic-side滑，但他们没有表现出显着的积极增益与单滑启动paratic-side相比，没有事先适应的控制。临床登记号：NCT 03205527。
This study examined if people with chronic stroke (PwCS) could adapt following non-paretic overground gait-slips and whether such prior exposure to non-paretic slips could improve reactive responses on novel paretic slip. Forty-nine PwCS were randomly assigned to either adaptation group, which received eight unexpected, overground, nonparetic-side gait-slips followed by two paretic-side slips or a control group, which received two paretic-side slips. Slip outcome, recovery strategies, center of mass (CoM) state stability, post-slip stride length and slipping kinematics were analyzed. The adaptation group demonstrated fall-reduction from first to eighth non-paretic slips, along with improved stability, stride length and slipping kinematics (p < 0.05). Within the adaptation group, on comparing novel slips, paretic-side demonstrated comparable pre-slip stability (p > 0.05); however, lower post-slip stability, increased slip velocity and falls was noted (p < 0.05). There was no difference in any variables between the novel paretic slips of adaptation and control group (p > 0.01). However, there was a rapid improvement on the 2nd slip such that adaptation group demonstrated improved performance from the first to second paretic slip compared to that in the control group (p < 0.01). PwCS demonstrated immediate proactive and reactive adaptation with overground, nonparetic-side gait-slips. However, PwCS did not demonstrate any inter-limb performance gain on the paretic-side after prior nonparetic-side adaptation when exposed to a novel paretic-side slip; but they did show significant positive gains with single slip priming on the paretic-side compared to controls without prior adaptation. Clinical registry number: NCT03205527.
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影响因子：
2.4
作者：
Cham, R;Redfern, MS
通讯作者：
Redfern, MS
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作者：
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通讯作者：
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影响因子：
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通讯作者：
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