Validation of a Speed-Based Classification System Using Quantitative Measures of Walking Performance Poststroke
Validation of a Speed-Based Classification System Using Quantitative Measures of Walking Performance Poststroke
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DOI：
10.1177/1545968308318837
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发表时间：
2008-11-01
影响因子：
4.2
通讯作者：
Kautz, Steven A.
中科院分区：
文献类型：
--
作者：
Bowden, Mark G.;Balasubramanian, Chitralakshmi K.;Kautz, Steven A.
背景对于中风康复的临床试验，自我选择的步行速度已被用于对人进行分层，以预测功能性步行状态并定义变化的临床意义。然而，这种分层主要使用自我报告问卷进行验证。Objective.本研究旨在通过步行性能的定量测量来验证基于速度的分类系统。方法.共有59名中风后偏瘫超过6个月的人参加了这项研究。时空和动力学的措施，包括由麻痹腿（Pp）产生的总推进的百分比，占的麻痹腿步长（PSR）的步幅的百分比，和在麻痹preswing（PPS）的步态周期的百分比。其他措施包括Fugl-Meyer评估的协同作用部分以及使用步行活动监测器测量的家庭和社区每天的平均步数。参与者按自选步态速度分为3组：家用（0.8 m/s）步行机。使用Kruskal-Wallis H检验和秩和检验事后分析分析组差异。结果分析表明，所有指标均存在主效应，但只有步数/天和PPS显示所有3组之间存在显著差异。结论.通过自我选择的步行速度对中风后个体进行分类与通过每日步数量化的基于家庭和社区的步行行为相关。此外，PPS区分了所有3组。Pp区分了中速组和快速组，并可能代表了增加步行速度的机制。速度分类是一种有用而简单的机制，可以对卒中后受试者进行分层，并可能与PPS的变化有机械联系。
Background. For clinical trials in stroke rehabilitation, self-selected walking speed has been used to stratify persons to predict functional walking status and to define clinical meaningfulness of changes. However, this stratification was validated primarily using self-report questionnaires. Objective. This study aims to validate the speed-based classification system with quantitative measures of walking performance. Methods. A total of 59 individuals who had hemiparesis for more than 6 months after stroke participated in this study. Spatiotemporal and kinetic measures included the percentage of total propulsion generated by the paretic leg (Pp), the percentage of the stride length accounted for by the paretic leg step length (PSR), and the percentage of the gait cycle spent in paretic preswing (PPS). Additional measures included the synergy portion of the Fugl-Meyer Assessment and the average number of steps/day in the home and community measured with a step activity monitor. Participants were stratified by self-selected gait speed into 3 groups: household (0.8 m/s) ambulators. Group differences were analyzed using a Kruskal-Wallis H test with rank sums test post hoc analyses. Results. Analyses demonstrated a main effect in all measures, but only steps/day and PPS demonstrated a significant difference between all 3 groups. Conclusions. Classifying individuals poststroke by self-selected walking speed is associated with home and community-based walking behavior as quantified by daily step counts. In addition, PPS distinguishes all 3 groups. Pp differentiates the moderate from the fast groups and may represent a contribution to mechanisms of increasing walking speed. Speed classification presents a useful yet simple mechanism to stratify subjects poststroke and may be mechanically linked to changes in PPS.