Walking speed changes in response to user-driven treadmill control after stroke
Walking speed changes in response to user-driven treadmill control after stroke
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DOI：
10.1016/j.jbiomech.2020.109643
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发表时间：
2020-03-05
影响因子：
2.4
通讯作者：
Higginson, Jill S.
中科院分区：
文献类型：
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作者：
Ray, Nicole T.;Reisman, Darcy S.;Higginson, Jill S.
本研究的目的是从步行速度、最大前地面反作用力(AGRF)、最大后地面反作用力(PGRF)和后肢角度(TLA)等方面确定中风后个体对用户驱动跑步机(UDTM)控制的反应。20名慢性中风患者在10米步行测试中走出地面，以确定他们的自选(SS)速度，然后在跑步机上以固定速度(FSTM)和UDTM控制模式以SS和最快舒适(Fast)速度行走。使用配对t检验比较不同测试条件之间的步行速度、峰值AGRF、峰值PGRF和TLA(α=0.05)。与FSTM对照组相比，参与者选择了与UDTM对照组相似的SS(p>；0.05)和更快的快速步行速度(p<；0.05)。在UDTM和FSTM条件下，肢体和速度的AGRF和PGRF峰值无明显变化(p>；0.05)。与UDTM对照组相比，在SS速度下，个体使用了更大的偏瘫TLA(p<；0.05)。在FSTM和UDTM控制下，快速时所需的AGRF没有差别，即使参与者选择了UDTM控制下的更快速度。在对年轻、健康的成年人进行的研究中，我们发现跑步机控制条件并不影响所需的向前推进量。因此，在UDTM控制下行走时，中风后的个体很可能会调整自己的姿势，以更好地利用他们的向前推进。这意味着他们可以在不增加推力的情况下达到更快的行走速度。未来的工作应该评估如何最有效地为步态训练计划规定UDTM控制。(C)2020爱思唯尔有限公司。保留所有权利。
The objective of this study was to determine how individuals poststroke respond to user-driven treadmill (UDTM) control in terms of walking speeds, peak anterior ground reaction forces (AGRF), peak posterior ground reaction forces (PGRF), and trailing limb angles (TLA). Twenty individuals with chronic stroke walked overground during a 10-meter walk test to determine their self-selected (SS) speeds before walking on a treadmill in its fixed-speed (FSTM) and UDTM control modes at their SS and fastest comfortable (Fast) speeds. Paired t-tests were used to compare the walking speeds, peak AGRF, peak PGRF, and TLA among test conditions (alpha = 0.05). Participants selected similar SS (p > 0.05) and faster Fast walking speeds (p < 0.05) with the UDTM control compared to the FSTM control. There were no changes in their peak AGRF or PGRF for either limb or speed between UDTM and FSTM conditions (p > 0.05). Individuals used greater paretic TLA at SS speeds with UDTM control (p < 0.05). There was no difference in the AGRF required at Fast speeds with FSTM and UDTM control even though participants selected faster speeds with UDTM control. In work with young, healthy adults, we found that the treadmill control condition did not affect the amount of forward propulsion needed. Therefore, it is likely that when walking with UDTM control, individuals poststroke adjust their posture to make better use of their forward propulsion. This means they can reach faster walking speeds without increasing their push-off forces. Future work should assess how to most effectively prescribe UDTM control for gait training programs. (C) 2020 Elsevier Ltd. All rights reserved.