Changes in the activation and function of the ankle plantar flexor muscles due to gait retraining in chronic stroke survivors.
Changes in the activation and function of the ankle plantar flexor muscles due to gait retraining in chronic stroke survivors.
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DOI：
10.1186/1743-0003-10-12
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发表时间：
2013-01-31
影响因子：
5.1
通讯作者：
Higginson JS
中科院分区：
文献类型：
--
作者：
Knarr BA;Kesar TM;Reisman DS;Binder-Macleod SA;Higginson JS
中风后患者的共同目标是恢复社区行走。足底屈肌肌肉在推进力产生和挥杆起始中起重要作用，如先前的肌肉骨骼模拟所示。本研究的目的是证明量化卒中后个体足底屈肌激活和功能变化的模拟结果与（1）旨在增强足底屈肌功能的干预目的和（2）基于既往文献的步态期间预期肌肉功能一致。创建三维正向动态模拟，以确定8例卒中后患者在12周FastFES步态再训练计划后的模型激活和瘫痪踝跖屈肌功能的变化。从干预前到干预后，在步态的双支撑阶段，所有跖屈肌的平均模拟激活中位值增加了0.07（范围[-0.01，0.22]）。对于8个受试者模拟中的7个，在干预后观察到步行速度和足底屈肌诱导的前向质心加速度的同时增加。此外，训练后，跖屈肌在双支撑期间对膝关节屈曲加速度的贡献模拟增加。首次使用肌肉驱动的肌肉骨骼模型来模拟步态再训练干预对中风后肌肉模型预测的激活和功能的影响。模拟显示了训练后足底屈肌肌肉模拟激活的新模式，这表明受试者在干预后以更合适的时机激活了这些肌肉。在功能上，模拟计算出足底屈肌在训练后对膝关节屈曲加速度提供了更大的贡献，这对于增加摆动阶段膝关节屈曲和足部间隙是重要的。
A common goal of persons post-stroke is to regain community ambulation. The plantar flexor muscles play an important role in propulsion generation and swing initiation as previous musculoskeletal simulations have shown. The purpose of this study was to demonstrate that simulation results quantifying changes in plantar flexor activation and function in individuals post-stroke were consistent with (1) the purpose of an intervention designed to enhance plantar flexor function and (2) expected muscle function during gait based on previous literature. Three-dimensional, forward dynamic simulations were created to determine the changes in model activation and function of the paretic ankle plantar flexor muscles for eight patients post-stroke after a 12-weeks FastFES gait retraining program. An median increase of 0.07 (Range [−0.01,0.22]) was seen in simulated activation averaged across all plantar flexors during the double support phase of gait from pre- to post-intervention. A concurrent increase in walking speed and plantar flexor induced forward center of mass acceleration by the plantar flexors was seen post-intervention for seven of the eight subject simulations. Additionally, post-training, the plantar flexors had an simulated increase in contribution to knee flexion acceleration during double support. For the first time, muscle-actuated musculoskeletal models were used to simulate the effect of a gait retraining intervention on post-stroke muscle model predicted activation and function. The simulations showed a new pattern of simulated activation for the plantar flexor muscles after training, suggesting that the subjects activated these muscles with more appropriate timing following the intervention. Functionally, simulations calculated that the plantar flexors provided greater contribution to knee flexion acceleration after training, which is important for increasing swing phase knee flexion and foot clearance.
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影响因子：
8.3
作者：
Bowden, MG;Balasubramanian, CK;Kautz, SA
通讯作者：
Kautz, SA
影响因子：
1.8
作者：
Nadeau, S;Gravel, D;Bourbonnais, D
通讯作者：
Bourbonnais, D
影响因子：
2.4
作者：
Neptune, Richard R.;Sasaki, Kotaro;Kautz, Steven A.
通讯作者：
Kautz, Steven A.
影响因子：
2.4
作者：
Goldberg, SR;Anderson, FC;Delp, SL
通讯作者：
Delp, SL
DOI：
10.1016/s0003-9993(03)00361-7
发表时间：
2003-10-01
影响因子：
4.3
作者：
Barbeau, H;Visintin, M
通讯作者：
Visintin, M