The differences in sagittal plane whole-body angular momentum during gait between patients with hemiparesis and healthy people
The differences in sagittal plane whole-body angular momentum during gait between patients with hemiparesis and healthy people
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DOI：
10.1016/j.jbiomech.2019.02.012
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发表时间：
2019-03-27
影响因子：
2.4
通讯作者：
Izumi, Shin-Ichi
中科院分区：
文献类型：
--
作者：
Honda, Keita;Sekiguchi, Yusuke;Izumi, Shin-Ichi
全身角动量（WBAM）的调节对于维持步态的动态平衡至关重要。轻偏瘫患者经常向前跌倒;然而，这是否是由于步态中矢状面WBAM控制受损所致仍不清楚。本研究旨在探讨偏瘫患者和健康人步态矢状面WBAM的差异。33名慢性脑卒中偏瘫患者和22名年龄和性别匹配的健康对照者沿着7米长的人行道行走，同时使用运动分析系统和测力板记录步态数据。在每个步态周期中，在矢状面上计算WBAM和关节力矩。对照组瘫痪步态周期后半段的矢状面WBAM范围明显大于右侧步态周期前、后半段（P = 0.015和P = 0.011）。多元回归分析显示，步行速度越慢（P < 0.001）和非瘫痪侧膝关节伸展力矩越大（P = 0.003），则瘫痪步态周期后半部分矢状面WBAM的范围越大。我们的研究结果表明，在矢状面的动态稳定性受损的麻痹步态周期的后半部分。此外，在偏瘫患者步态中，非瘫痪侧的大的膝关节伸展力矩可能在矢状面的动态不稳定性中起作用。(C)2019爱思唯尔有限公司版权所有。
Regulation of whole-body angular momentum (WBAM) is essential for maintaining dynamic balance during gait. Patients with hemiparesis frequently fall toward the anterior direction; however, whether this is due to impaired WBAM control in the sagittal plane during gait remains unknown. The present study aimed to investigate the differences in WBAM in the sagittal plane during gait between patients with hemiparesis and healthy individuals. Thirty-three chronic stroke patients with hemiparesis and twenty-two age- and gender-matched healthy controls walked along a 7-m walkway while gait data were recorded using a motion analysis system and force plates. WBAM and joint moment were calculated in the sagittal plane during each gait cycle. The range of WBAM in the sagittal plane in the second half of the paretic gait cycle was significantly larger than that in the first and second halves of the right gait cycle in the controls (P = 0.015 and P = 0.011). Furthermore, multiple regression analysis revealed the slower walking speed (P < 0.001) and larger knee extension moment on the non-paretic side (P = 0.003) contributed to the larger range of WBAM in the sagittal plane in the second half of the paretic gait cycle. Our findings suggest that dynamic stability in the sagittal plane is impaired in the second half of the paretic gait cycle. In addition, the large knee extension moment on the non-paretic side might play a role in the dynamic instability in the sagittal plane during gait in patients with hemiparesis. (C) 2019 Elsevier Ltd. All rights reserved.