Reactive balance to unanticipated trip-like perturbations: a treadmill-based study examining effect of aging and stroke on fall risk
Reactive balance to unanticipated trip-like perturbations: a treadmill-based study examining effect of aging and stroke on fall risk
复制标题
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
DOI：
10.1080/23335432.2018.1512375
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发表时间：
2018-09-21
影响因子：
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通讯作者：
Bhatt T
中科院分区：
文献类型：
--
作者：
Joshi M;Patel P;Bhatt T
这项研究的目的是研究社区居住的偏瘫中风幸存者在站立状态下暴露于突然的、绊状的支撑面扰动时跌倒风险的机制。参与者(n=14/组)包括中风幸存者、年龄相仿的老年对照组(AC)和在机动跑步机上经历旅行样扰动的青年对照组(YC)。主要结果是COM状态控制(测量COM位置(XCOM/BOS)和相对于支撑基座(BOS)的速度(VCOM/BOS))和垂直肢体支持记录为髋关节下降的程度。所有参与者都表现出前向失去平衡(FLOB)，然后是相等的第一代偿步长。在阶梯着地时，中风幸存者表现出比YC组更低的COM状态稳定性和更高的躯干屈曲。中风幸存者也表现出比YC组和AC组更大的髋关节下沉，因为他们第一次用非瘫痪的肢体行走。在第二个代偿步骤中，中风幸存者用他们瘫痪的肢体迈步。然而，与AC组不同的是，尽管采取了较长的补偿步骤，但他们无法控制VCOM/BOS。综上所述，COM状态控制不良、躯干控制受损以及偏瘫肢体不能提供垂直肢体支撑可能是中风幸存者跌倒风险较高的原因。
The purpose of this study was to examine the mechanism of fall risk in community-dwelling ambulatory hemiplegic stroke survivors when exposed to a sudden, trip-like support surface perturbation in standing. Participants (n = 14 / group) included stroke survivors, Age-similar older controls (AC), and Young controls (YC) experienced trip-like perturbation on a motorized treadmill. The primary outcomes were COM state control (measured as COM position (XCOM/BOS) and velocity (VCOM/BOS) relative to the base of support (BOS)) and the vertical limb support recorded as the extent of hip descent. All participants demonstrated forward loss of balance (FLOB) followed by an equal first compensatory step length. At step touchdown, stroke survivors demonstrated lower COM state stability and increased trunk flexion than the YC group. Stroke survivors also demonstrated greater hip descent than YC and AC groups, as they first stepped with their non-paretic limb. For the second compensatory step, the stroke survivors stepped with their paretic limb. However, unlike the AC group, they were unable to control VCOM/BOS despite a longer compensatory step. In conclusion, poor control of COM state, impaired trunk control and inability of the paretic limb to provide vertical limb support may explain the higher fall-risk in stroke survivors.