Biomechanical control of paretic lower limb during imposed weight transfer in individuals post-stroke.
Biomechanical control of paretic lower limb during imposed weight transfer in individuals post-stroke.
复制标题
势力后施加体重转移期间，对paretic下肢的生物力学控制。
DOI：
10.1186/s12984-020-00768-1
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发表时间：
2020-10-27
影响因子：
5.1
通讯作者：
Rogers MW
中科院分区：
文献类型：
--
作者：
Hsiao HY;Gray VL;Borrelli J;Rogers MW
中风是导致偏瘫的主要原因，导致偏瘫难以承受重量并将重量转移到偏瘫肢体上。负重和重量转移困难可能会导致活动能力和平衡能力受损、跌倒风险增加以及社区参与度下降。尽管为了改善中风后的重量转移付出了巨大的努力，但对其神经运动和生物力学控制的损害仍然知之甚少。在本研究中，使用一种新颖的实验范式来表征慢性中风患者与健全对照者的体重转移生物力学差异。十五名中风参与者和十五名年龄匹配的健全对照者参与了这项研究。参与者将一只脚站在两个定制平台上。其中一个平台垂直下降 4.3 厘米，以引起横向重量转移和承重。分析中包括涉及将平台掉落到瘫痪下肢（用于控制的非优势肢体）下方的试验。测量了瘫痪下肢关节运动学、垂直地面反作用力和压力中心速度。所有参与者均完成了临床阶梯测试和四方阶梯测试。与对照组相比，中风组的瘫痪踝关节、膝关节和髋关节角位移和速度减少，踝关节和膝关节间时间延迟，质心向下位移增加，压力中心（COP）速度稳定时间增加。此外，诱导重量转移期间的麻痹 COP 速度稳定时间可预测中风后个体的四方步测试分数。与对照组相比，诱导重量转移方法在控制偏瘫肢体侧的重量转移方面发现了与中风相关的异常。瘫痪踝关节和膝关节屈曲的减少、关节间时间的改变以及 COP 稳定时间的增加可能反映了中风后体重转移过程中神经肌肉控制的困难。未来的工作将研究通过诱导重量转移训练练习改善功能性重量转移的潜力。
Stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls Fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. The induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.
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影响因子：
37.8
作者：
Go AS;Mozaffarian D;Roger VL;Benjamin EJ;Berry JD;Blaha MJ;Dai S;Ford ES;Fox CS;Franco S;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Huffman MD;Judd SE;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Mackey RH;Magid DJ;Marcus GM;Marelli A;Matchar DB;McGuire DK;Mohler ER 3rd;Moy CS;Mussolino ME;Neumar RW;Nichol G;Pandey DK;Paynter NP;Reeves MJ;Sorlie PD;Stein J;Towfighi A;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
影响因子：
4.2
作者：
Awad LN;Palmer JA;Pohlig RT;Binder-Macleod SA;Reisman DS
通讯作者：
Reisman DS
影响因子：
3.7
作者：
Igawa, Tatsuya;Katsuhira, Junji;Matsudaira, Ko
通讯作者：
Matsudaira, Ko
DOI：
10.1016/s0003-9993(95)80631-8
发表时间：
1995-07-01
影响因子：
4.3
作者：
BRUNT, D;VANDERLINDEN, DW;BEHRMAN, AL
通讯作者：
BEHRMAN, AL
影响因子：
5.1
作者：
Bulea, Thomas C.;Kobetic, Rudi;Triolo, Ronald J.
通讯作者：
Triolo, Ronald J.