Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke: from individual limbs to lower limb joints.
Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke: from individual limbs to lower limb joints.
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DOI：
10.1186/s12984-015-0012-x
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发表时间：
2015-02-27
影响因子：
5.1
通讯作者：
Sawicki GS
中科院分区：
文献类型：
--
作者：
Farris DJ;Hampton A;Lewek MD;Sawicki GS
先前关于中风后偏瘫行走的力学和能量学的报道要么没有结合机械和代谢能的估计，要么没有基于有限组合肢体方法计算外部机械功。在这里，我们提出的力学和能量学的比较偏瘫和未受损的步行在匹配的速度。采用单肢法计算身体质心所做的机械功，采用逆动力学分析计算单个腿关节所做的功。这两个估计值都转换为平均功率，并与通过间接量热法确定的净代谢功率的同时估计值相关。正功效率计算为平均正机械功率与净代谢功率之比。偏瘫组(H)的总重量比未受损对照组(C)大20% （0.49 vs. 0.41 W·kg−1）。更大的部分原因是偏瘫步行者的麻痹肢体在一步到一步的过渡中没有提供适当的时间推离。这导致代偿性非麻痹肢体、髋关节和膝关节产生更大的总机械功。正功效率在H和c之间没有差异，增加了功，而不是降低了效率，解释了中风后偏瘫步行的代谢成本更高。我们的研究结果强调需要通过治疗或辅助技术来改善偏瘫踝关节蹬离，以减少偏瘫行走的代谢成本。
Previous reports of the mechanics and energetics of post-stroke hemiparetic walking have either not combined estimates of mechanical and metabolic energy or computed external mechanical work based on the limited combined limbs method. Here we present a comparison of the mechanics and energetics of hemiparetic and unimpaired walking at a matched speed. Mechanical work done on the body centre of mass (COM) was computed by the individual limbs method and work done at individual leg joints was computed with an inverse dynamics analysis. Both estimates were converted to average powers and related to simultaneous estimates of net metabolic power, determined via indirect calorimetry. Efficiency of positive work was calculated as the ratio of average positive mechanical power to net metabolic power. Total was 20% greater for the hemiparetic group (H) than for the unimpaired control group (C) (0.49 vs. 0.41 W · kg−1). The greater was partly attributed to the paretic limb of hemiparetic walkers not providing appropriately timed push-off in the step-to-step transition. This led to compensatory non-paretic limb hip and knee which resulted in greater total mechanical work. Efficiency of positive work was not different between H and C. Increased work, not decreased efficiency, explains the greater metabolic cost of hemiparetic walking post-stroke. Our results highlighted the need to target improving paretic ankle push-off via therapy or assistive technology in order to reduce the metabolic cost of hemiparetic walking.
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DOI：
10.1115/1.2798313
发表时间：
1998-04-01
影响因子：
1.7
作者：
Garcia, M;Chatterjee, A;Coleman, M
通讯作者：
Coleman, M
影响因子：
2.4
作者：
Soo, Caroline H.;Donelan, J. Maxwell
通讯作者：
Donelan, J. Maxwell
DOI：
10.1115/1.1427703
发表时间：
2002-02-01
影响因子：
1.7
作者：
Kuo, AD
通讯作者：
Kuo, AD
影响因子：
2.8
作者：
Sasaki, Kotaro;Neptune, Richard R.;Kautz, Steven A.
通讯作者：
Kautz, Steven A.
影响因子：
2.4
作者：
Wutzke, Clinton J.;Sawicki, Gregory S.;Lewek, Michael D.
通讯作者：
Lewek, Michael D.