Adaptation process for standing postural control in individuals with hemiparesis
Adaptation process for standing postural control in individuals with hemiparesis
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DOI：
10.3109/09638288.2011.579226
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发表时间：
2011-01-01
影响因子：
2.2
通讯作者：
Liu, Meigen
中科院分区：
文献类型：
--
作者：
Kiyota, Yasuhiro;Hase, Kimitaka;Liu, Meigen
目的.研究脑卒中偏瘫患者站立姿势控制的适应过程。对9例偏瘫患者（年龄48-62岁，中风后6-19天）的站立姿势进行了观察，记录了下肢的地面反作用力和表面肌电（EMG）。在无任何身体姿势指导的情况下，重复进行5次60 s的站立试验，并估计压力中心（COP）和综合肌电图数据的经验相关变化。在早期站立试验中，患者通过管理双脚中线周围的平均COP位置来平衡自己，同时增加非麻痹腿的肌肉活动。COP位移在站立试验后期逐渐降低（P < 0.05）。通过将身体摇摆中心转移到非麻痹足的一侧（P < 0.05），同时减少非麻痹足的股二头肌肌肉活动（P < 0.01）来实现姿势适应。这项研究表明，负重不对称可能有助于改善增加身体摇摆和肌肉过度活动的非麻痹腿。在规划偏瘫患者的复健治疗时，我们应该考虑到负重不对称可能是系统性姿势控制的结果。
Purpose. To study the adaptation process for standing postural control in patients with hemiparesis after stroke.Methods. The changes of a standing posture developed in nine hemiparetic patients who had never maintained an upright stance alone (aged 48-62 years; 6-19 days after stroke) was evaluated by recording ground reaction forces and surface electromyographic (EMG) from lower limbs. A 60-s standing trial without any instruction about body alignment was repeated five times, and the experience-related changes of centre of pressure (COP) and integrated EMG data were estimated.Results. In the early standing trials, patients balanced themselves by managing the average COP position around the midline of both feet, accompanied by increased muscular activity of the non-paretic leg. COP displacement gradually decreased in the later standing trials (P < 0.05). Postural adaptations were achieved by shifting the centre of body sway to the side of the non-paretic foot (P < 0.05) while reducing biceps femoris muscular activity (P < 0.01) in the non-paretic leg.Conclusions. This study revealed that weight-bearing asymmetry might contribute to improving increased body sway and muscular over-activity of the non-paretic leg. When planning rehabilitative treatment for hemiparetic patients, we should consider that weight-bearing asymmetry may be a result of systematic postural control.