Immediate improvements in post-stroke gait biomechanics are induced with both real-time limb position and propulsive force biofeedback.
Immediate improvements in post-stroke gait biomechanics are induced with both real-time limb position and propulsive force biofeedback.
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即时改善中风后步态生物力学与实时肢体位置和推进力生物反馈。
DOI：
10.1186/s12984-023-01154-3
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发表时间：
2023-03-31
影响因子：
5.1
通讯作者：
Kesar, Trisha M.
中科院分区：
文献类型：
--
作者：
Santucci, Vincent;Alam, Zahin;Liu, Justin;Spencer, Jacob;Faust, Alec;Cobb, Aijalon;Konantz, Joshua;Eicholtz, Steven;Wolf, Steven;Kesar, Trisha M.
偏瘫推进力[测量为前向地面反作用力(AGRF)]和后肢角度(TLA)显示出强大的相互关系，并代表了两个关键的可修改的卒中后步态变量，具有生物力学和临床相关性。我们最近的工作表明，实时生物反馈是调节健全参与者的AGRF和TLA的一个可行的范例。然而，TLA生物反馈对中风后个体步态生物力学的影响还知之甚少。因此，我们的目标是研究单侧、实时、视听TLA和AGRF生物反馈对中风后个体步态生物力学的影响。9名卒中后个体(6名男性，年龄63 ±TLA9.8岁，卒中后44.9月)参加了由三种类型的步行试验组成的单次步态分析：无生物反馈、 生物反馈和TLA生物反馈。生物反馈单方面针对瘫痪肢体上的缺陷。因变量包括峰值AGRF、TLA和踝屈肌力矩。采用单向重复测量方差分析和Bonferroni校正后比较，检测生物反馈对步态生物力学变量的影响。与无生物反馈相比，AGRF和TLA生物反馈均导致偏瘫患者AGRF单侧增加。TLA生物反馈对偏瘫患者TLA的影响明显大于AGRF生物反馈。AGRF生物反馈增加了踝关节力矩，两种反馈条件都增加了非轻瘫患者的步长。这两种类型的生物反馈都专门针对瘫痪肢体，而不会导致非瘫痪肢体的变化。通过显示瘫痪肢体步态生物力学在TLA和AGRF生物反馈下的类似增加，我们的新发现为中风后患者提供了TLA作为步态生物反馈靶点的理论基础和可行性。此外，我们的结果为这两个生物反馈靶点改善卒中后步态的不同生物力学机制提供了初步的见解。我们为未来的研究奠定了基础，纳入了更大剂量的TLA生物反馈作为中风步态康复策略的长期疗效。试用登记NCT03466372
Paretic propulsion [measured as anteriorly-directed ground reaction forces (AGRF)] and trailing limb angle (TLA) show robust inter-relationships, and represent two key modifiable post-stroke gait variables that have biomechanical and clinical relevance. Our recent work demonstrated that real-time biofeedback is a feasible paradigm for modulating AGRF and TLA in able-bodied participants. However, the effects of TLA biofeedback on gait biomechanics of post-stroke individuals are poorly understood. Thus, our objective was to investigate the effects of unilateral, real-time, audiovisual TLA versus AGRF biofeedback on gait biomechanics in post-stroke individuals. Nine post-stroke individuals (6 males, age 63 ± 9.8 years, 44.9 months post-stroke) participated in a single session of gait analysis comprised of three types of walking trials: no biofeedback, AGRF biofeedback, and TLA biofeedback. Biofeedback unilaterally targeted deficits on the paretic limb. Dependent variables included peak AGRF, TLA, and ankle plantarflexor moment. One-way repeated measures ANOVA with Bonferroni-corrected post-hoc comparisons were conducted to detect the effect of biofeedback on gait biomechanics variables. Compared to no-biofeedback, both AGRF and TLA biofeedback induced unilateral increases in paretic AGRF. TLA biofeedback induced significantly larger increases in paretic TLA than AGRF biofeedback. AGRF biofeedback increased ankle moment, and both feedback conditions increased non-paretic step length. Both types of biofeedback specifically targeted the paretic limb without inducing changes in the non-paretic limb. By showing comparable increases in paretic limb gait biomechanics in response to both TLA and AGRF biofeedback, our novel findings provide the rationale and feasibility of paretic TLA as a gait biofeedback target for post-stroke individuals. Additionally, our results provide preliminary insights into divergent biomechanical mechanisms underlying improvements in post-stroke gait induced by these two biofeedback targets. We lay the groundwork for future investigations incorporating greater dosages and longer-term therapeutic effects of TLA biofeedback as a stroke gait rehabilitation strategy. Trial registration NCT03466372
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paretic推进和尾肢角是中风后长距离步行功能的关键决定因素。
影响因子：
4.2
作者：
Awad LN;Binder-Macleod SA;Pohlig RT;Reisman DS
通讯作者：
Reisman DS
影响因子：
8.3
作者：
Bowden, MG;Balasubramanian, CK;Kautz, SA
通讯作者：
Kautz, SA
影响因子：
8.3
作者：
INTISO, D;SANTILLI, V;CARUSO, I
通讯作者：
CARUSO, I
影响因子：
3
作者：
Liu, Justin;Kim, Hyun Bin;Kesar, Trisha M.
通讯作者：
Kesar, Trisha M.
影响因子：
4.2
作者：
Lewek, Michael D.;Raiti, Cristina;Doty, Amanda
通讯作者：
Doty, Amanda