Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke
Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke
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DOI：
10.1016/j.clinbiomech.2013.02.001
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发表时间：
2013-04-01
影响因子：
1.8
通讯作者：
Curtis, Amy B.
中科院分区：
文献类型：
--
作者：
Combs, Stephanie A.;Dugan, Eric L.;Curtis, Amy B.
背景：运动干预通常使用功能结果进行评估，但这些结果提供的有关恢复或补偿机制变化的信息有限。研究目的是检查因中风导致的慢性偏瘫患者在进行体重支撑跑步机训练后步态对称性和双侧协调性的变化，并将结果与无残疾的参与者进行比较。方法：19 名行走速度在 0.4 至 0.8 m/s 之间的中风参与者（>6 个月）和 22 名无残疾的参与者参加了这项重复测量研究。中风组在 8 周内完成了 24 次干预课程，每次步行 20 分钟。非残疾组作为描述对称性和协调性变化的比较。在 3 个时间点（测试前、测试后立即和 6 个月保留）评估双边 3 维运动分析和步态速度。使用连续相对相位来评估双侧协调性（大腿-大腿、小腿-小腿、足-足），并通过时空比率（步长、摆动时间、站立时间）评估步态对称性。结果：中风组在测试后和保持时发现连续相对相位（小腿-小腿和足-足耦合）有显着改善。随着时间的推移，没有发现时空对称性比率的显着差异。与非残疾组相比，双侧协调性的变化朝着正常恢复的方向发展。大多数连续相对相位测量比时空比率对训练后的变化更敏感。解释：在体重支持的跑步机训练后，中风组在恢复正常双侧协调方面取得了进步。双边协调和步态对称性测量可以评估步态的不同方面。 (C) 2013 Elsevier Ltd. 保留所有权利。
Background: Locomotor interventions are commonly assessed using functional outcomes, but these outcomes provide limited information about changes toward recovery or compensatory mechanisms. The study purposes were to examine changes in gait symmetry and bilateral coordination following body-weight supported treadmill training in individuals with chronic hemiparesis due to stroke and to compare findings to participants without disability.Methods: Nineteen participants with stroke (>6 months) who ambulated between 0.4 and 0.8 m/s and 22 participants without disability were enrolled in this repeated-measures study. The stroke group completed 24 intervention sessions over 8 weeks with 20 minutes of walking/session. The non-disabled group served as a comparison for describing changes in symmetry and coordination. Bilateral 3-dimensional motion analysis and gait speed were assessed across 3 time points (pre-test, immediate post-test, and 6-month retention). Continuous relative phase was used to evaluate bilateral coordination (thigh-thigh, shank-shank, foot-foot) and gait symmetry was assessed with spatiotemporal ratios (step length, swing time, stance time).Findings: Significant improvements in continuous relative phase (shank-shank and foot-foot couplings) were found at post-test and retention for the stroke group. Significant differences in spatiotemporal symmetry ratios were not found over time. Compared to the non-disabled group, changes in bilateral coordination moved in the direction of normal recovery. Most measures of continuous relative phase were more responsive to change after training than the spatiotemporal ratios.Interpretations: After body-weight supported treadmill training, the stroke group made improvements toward recovery of normal bilateral coordination. Bilateral coordination and gait symmetry measures may assess different aspects of gait. (C) 2013 Elsevier Ltd. All rights reserved.