Muscle contributions to support during gait in an individual with post-stroke hemiparesis
Muscle contributions to support during gait in an individual with post-stroke hemiparesis
复制标题
DOI：
10.1016/j.jbiomech.2005.05.032
复制
发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Delp, S. L.
中科院分区：
文献类型：
--
作者：
Higginson, J. S.;Zajac, F. E.;Delp, S. L.
走路需要协调肌肉来支持身体在单一的立场。中风后协调肌肉的能力受损经常会影响步行能力，导致步行速度极低。中风后轻偏瘫的缓慢步态由于下肢肌肉兴奋的不对称而进一步复杂化。本研究的目的是：（1）比较中风后轻偏瘫患者与健康成人缓慢行走患者的肌肉协调模式，以及（2）确定轻瘫和非轻瘫肌肉如何为该患者的身体质心提供支持。基于中风幸存者以他自己选择的速度（0.3m/s）行走的运动学和动力学以及三个速度匹配的健康老年人的运动学和动力学生成模拟。对于每个模拟，肌肉力被扰动以确定对体重支撑贡献最大的肌肉（即，中间姿态期间的质心高度）。肌肉兴奋和中期身体配置的差异导致瘫痪和非瘫痪踝跖屈肌的中期支持比健康的缓慢步态。麻痹踝背屈肌和膝屈肌在站立时的兴奋对抗支撑，需要膝和髋伸肌的补偿。在患有中风后轻偏瘫的个体的步态期间，通过相对于健康缓慢步态的轻瘫和非轻瘫下肢的重组肌肉协调模式来提供足够的体重支撑。爱思唯尔有限公司出版
Walking requires coordination of muscles to support the body during single stance. Impaired ability to coordinate muscles following stroke frequently compromises walking performance and results in extremely low walking speeds. Slow gait in post-stroke hemiparesis is further complicated by asymmetries in lower limb muscle excitations. The objectives of the current study were: (1) to compare the muscle coordination patterns of an individual with flexed stance limb posture secondary to post-stroke hemiparesis with that of healthy adults walking very slowly, and (2) to identify how paretic and non-paretic muscles provide support of the body center of mass in this individual. Simulations were generated based on the kinematics and kinetics of a stroke survivor walking at his self-selected speed (0.3m/s) and of three speed-matched, healthy older individuals. For each simulation, muscle forces were perturbed to determine the muscles contributing most to body weight support (i.e., height of the center of mass during midstance). Differences in muscle excitations and midstance body configuration caused paretic and non-paretic ankle plantarflexors to contribute less to midstance support than in healthy slow gait. Excitation of paretic ankle dorsiflexors and knee flexors during stance opposed support and necessitated compensation by knee and hip extensors. During gait for an individual with post-stroke hemiparesis, adequate body weight support is provided via reorganized muscle coordination patterns of the paretic and non-paretic lower limbs relative to healthy slow gait. Published by Elsevier Ltd.