Hemiparetic gait parameters in overground versus treadmill walking
Hemiparetic gait parameters in overground versus treadmill walking
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DOI：
10.1177/154596830101500204
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发表时间：
2001-01-01
影响因子：
4.2
通讯作者：
Smith, GV
中科院分区：
文献类型：
--
作者：
Harris-Love, ML;Forrester, LW;Smith, GV
目的：偏瘫步态的特征是高步幅周期变异性，减少站立时间，单肢站立时间，和立场/摆动比在瘫痪的肢体。最近的研究表明，跑步机（TM）训练可能会改善这些变量背后的运动控制，但支持的证据很少。研究方法：本研究比较了未经训练的慢性轻偏瘫卒中患者（n = 18;平均，卒中后39.5个月）在地面（OG）和TM以匹配速度行走时的步态模式。变量包括相对站立时间、相对单肢站立时间、站立/摆动比、峰值力和冲量。这些措施（CV）的受试者内变异性被用来评估步态模式的稳定性。结果：OG和TM周期持续时间相似，但CV不同（TM < OG，p < 0.05）。在麻痹肢体中，分别在相对站立时间、相对单肢、肢体站立时间和站立/摆动比上观察到差异（TM > OG，p < 0.05）。在TM行走过程中，这些变量在非麻痹肢体中降低（所有p < 0.05）。在TM条件下，改善的肢体间对称性和协调性分别通过减少肢体间差异和改善的相对时间相位来证明（p < 0.05）。结论：总的来说，这些结果表明，TM诱导立即改变走向更一致和对称的步态模式。需要进一步的研究来确定TM训练是否会导致慢性偏瘫患者的运动再学习和神经可塑性。
Objective: Hemiparetic gait is characterized by high stride-cycle variability, diminished stance time, single-limb stance time, and stance/swing ratio in the paretic limb. Recent studies suggest treadmill (TM) training may improve the motor control underlying these variables, but supporting evidence is sparse. Methods: This study compared gait patterns of untrained chronic hemiparetic stroke patients (n = 18; mean, 39.5 months poststroke) during overground (OG) and TM walking at matched velocities. Variables included relative stance time, relative single-limb stance time, stance/swing ratio, peak force, and impulse. Within-subject variability of these measures (CV) was used to assess gait pattern stability. Results: OG and TM cycle durations were similar, but CVs differed (TM < OG, p < 0.05). In the paretic limb, differences were seen in relative stance time, relative single,limb stance time, and stance/swing ratio, respectively (TM > OG, p < 0.05). These variables decreased in the nonparetic limb during TM walking (p < 0.05 for all). Improved interlimb symmetry and coordination were evidenced by decreased between-limb differences and improved relative temporal phasing, respectively, in the TM condition (p < 0.05). Conclusions: Collectively, these results demonstrate that the TM induces an immediate alteration toward a more consistent and symmetric gait pattern. Further investigation is needed to determine whether TM training leads to motor relearning and neuroplasticity in chronic hemiparetic subjects.