Does stroke-induced sensorimotor impairment and perturbation intensity affect gait-slip outcomes?
Does stroke-induced sensorimotor impairment and perturbation intensity affect gait-slip outcomes?
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DOI：
10.1016/j.jbiomech.2021.110255
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发表时间：
2021-03-30
影响因子：
2.4
通讯作者：
Bhatt T
中科院分区：
文献类型：
--
作者：
Dusane S;Gangwani R;Patel P;Bhatt T
慢性中风(PWCS)患者在偏瘫和非偏瘫侧都表现出相似的步态滑倒风险。代偿性踏步和滑肢控制是降低步态滑倒风险的关键。考虑到现实生活中不可预测的干扰强度，这项研究的目的是确定从偏瘫或非偏瘫滑脱中恢复是否随着干扰强度的变化而变化。44例PWCS分为非偏瘫低强度滑移组、非偏瘫高强度滑移组、偏瘫低强度滑移组和偏瘫高强度滑移组。参与者接受了一种新的地面步态滑移，距离为24厘米(低)或45厘米(高)，位于两个肢体下方。分析了恢复策略、质心状态稳定性和滑移运动学。非轻瘫患者高强度组和低强度组的步幅流失率和恢复率相似，但轻瘫高强度组的步幅流失率高于非轻瘫组(p>；0.05)。高强度和低强度轻瘫滑脱组与非轻瘫滑脱组相比，滑脱后COM稳定性均降低(p<；0.05)。偏瘫高压组滑移大于非偏瘫高压组(P<；0.05)。只有偏瘫滑动组在高强度时有更大的滑移(p<；0.05)。偏瘫组滑移速度明显快于非偏瘫滑动组(P<；0.05)。与非瘫痪滑脱相比，轻瘫滑脱表现出较低的稳定性，这与难以调节滑移运动学和采用更多的中止步进策略有关。这些发现建议开发平衡干预措施，既改善非瘫痪肢体的代偿性踏步，又改善对滑脱肢体的反应控制，以降低跌倒风险。
People with chronic stroke (PwCS) demonstrate similar gait-slip fall-risk on both paretic and non-paretic side. Compensatory stepping and slipping limb control are crucial to reduce gait-slip fall-risk. Given the unpredictable intensities of real-life perturbations, this study aimed to determine whether recovery from paretic or non-paretic slips vary as a function of perturbation intensity among PwCS. Forty-four PwCS were assigned to non-paretic low intensity slip, non-paretic high intensity slip, paretic low intensity slip, or paretic high intensity slip group. Participants were subjected to a novel overground gait-slip with a distance of 24 cm (low) or 45 cm (high), under either limb. Recovery strategies, center of mass (CoM) state stability and slipping kinematics were analyzed. Both non-paretic high and low intensity groups demonstrated similar percentage of aborted and recovery stepping, however, paretic high intensity group demonstrated greater aborted stepping (p > 0.05). Both high and low intensity paretic slip groups demonstrated reduced post-slip CoM stability relative to the non-paretic slip groups (p < 0.05). Slip displacement was greater in paretic high group compared with non-paretic high group (p < 0.05). Greater slip displacement at higher intensity was noted only in paretic slip group (p < 0.05). The slip velocity was faster in paretic groups compared to non-paretic slip groups (p < 0.05). Paretic slips showed lower stability at both intensities associated with difficulty in modulating slipping kinematics and resorting to an increased aborted stepping strategy compared to non-paretic slip. These findings are suggestive of developing balance interventions for improving both compensatory non-paretic limb stepping and reactive control of slipping paretic limb for fall-risk reduction.
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影响因子：
2.4
作者：
Cham, R;Redfern, MS
通讯作者：
Redfern, MS
影响因子：
2.5
作者：
HORAK, FB;DIENER, HC
通讯作者：
DIENER, HC
反应性平衡与意外的旅行样扰动：基于跑步机的研究检查衰老和中风对跌落风险的影响
影响因子：
--
作者：
Joshi M;Patel P;Bhatt T
通讯作者：
Bhatt T
影响因子：
4.8
作者：
Bastian AJ
通讯作者：
Bastian AJ
影响因子：
2
作者：
Doumas, Michail;Smolders, Caroline;Krampe, Ralf Th.
通讯作者：
Krampe, Ralf Th.