Capacity to increase walking speed is limited by impaired hip and ankle power generation in lower functioning persons post-stroke.
Capacity to increase walking speed is limited by impaired hip and ankle power generation in lower functioning persons post-stroke.
复制标题
DOI：
10.1016/j.gaitpost.2008.07.010
复制
发表时间：
2009-01
期刊：
影响因子：
2.4
通讯作者：
Patten, C.
中科院分区：
文献类型：
--
作者：
Jonkers, I.;Delp, S.;Patten, C.
虽然有限的步行速度是大多数中风后步态的特征，但提高步行速度的潜力也可能显著受损，尚未得到彻底的调查。我们假设，未能有效地招募瘫痪侧的髋屈肌和趾屈肌，限制了功能较低的偏瘫受试者提高步行速度的潜力。为了验证这一假设，我们测量了12名中风后偏瘫患者在自己选择的快速行走条件下的步态运动学和力学。实验分为两组：1)低功能受试者(n=6)，正常化步行速度从0.52腿/秒(ll/S，扫描电镜：0.04)提高到0.72 ll/S(扫描电镜：0.03)；2)高功能受试者(n=6)，步行速度从0.88 ll/S(扫描电镜：0.04)提高到1.4 ll/S(扫描电镜：0.03)。比较自选和快走在匹配速度(0.35ll/S(扫描电镜：0.03)-0.63ll/S(扫描电子显微镜：0.03)-0.92ll/S(扫描电子显微镜：0.04)和1.4ll/S(扫描电子显微镜：0.04))下的时空参数、关节运动学和动力学的变化。与速度匹配的对照组受试者相似，高功能偏瘫受试者增加截瘫肢体髋关节屈曲力量和踝关节屈膝力量以增加步行速度。功能较低的受试者在摆动前以他们自己选择的速度表现出踝关节发电量受损，并伴有偏瘫髋部的过度发电量。这组功能较低的人没有增加臀部或脚踝的发电量来提高步行速度。这一观察表明，踝关节动力产生受损，加上髋关节动力产生饱和，限制了较低功能偏瘫受试者提高步行速度的潜力。
While limited walking speed characterizes gait in the majority of persons post-stroke, the potential to increase walking speed can also be markedly impaired and has not been thoroughly investigated. We hypothesized that failure to effectively recruit both hip flexor and plantarflexor muscles of the paretic side limits the potential to increase walking speed in lower functioning hemiparetic subjects. To test this hypothesis, we measured gait kinematics and mechanics of twelve persons with post-stroke hemiparesis at self-selected and fast walking conditions. Two groups were identified: 1) lower functioning subjects (n=6) who increased normalized walking speed from 0.52 leg lengths/sec (ll/s, SEM: 0.04) to 0.72 ll/s (SEM: 0.03) and 2) higher functioning subjects (n = 6) who increased walking speed from 0.88 ll/s (SEM:0.04) to 1.4 ll/s (SEM 0.03). Changes in spatiotemporal parameters, joint kinematics and kinetics between self-selected and fast walking were compared to control data collected at matched speeds (0.35 ll/s (SEM: 0.03) - 0.63 ll/s (SEM: 0.03) - 0.92 ll/s (SEM: 0.04) and 1.4 ll/s (SEM: 0.04)). Similar to speed-matched control subjects, the higher functioning hemiparetic subjects increased paretic limb hip flexion power and ankle plantarflexion power to increase walking speed. The lower functioning subjects demonstrated impaired ankle power generation combined with excessive power generation at the paretic hip during pre-swing at their self selected speed. This lower functioning group did not increase power generation at the hip or ankle to increase walking speed. This observation suggests that impaired ankle power generation combined with saturation of hip power generation, limits the potential to increase walking speed in lower functioning hemiparetic subjects.
登录
查看更多内容
影响因子：
1.8
作者：
Nadeau, S;Gravel, D;Bourbonnais, D
通讯作者：
Bourbonnais, D
DOI：
10.1016/s0003-9993(03)00030-3
发表时间：
2003-08-01
影响因子：
4.3
作者：
Hsu, AL;Tang, PF;Jan, MH
通讯作者：
Jan, MH
影响因子：
2.4
作者：
den Otter, AR;Geurts, ACH;Duysens, J
通讯作者：
Duysens, J
影响因子：
1.7
作者：
van der Linden, ML;Kerr, AM;Robb, JE
通讯作者：
Robb, JE
影响因子：
4.2
作者：
Bayat, R;Barbeau, H;Lamontagne, A
通讯作者：
Lamontagne, A