Evidence of abnormal lower-limb torque coupling after stroke - An isometric study
Evidence of abnormal lower-limb torque coupling after stroke - An isometric study
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DOI：
10.1161/strokeaha.107.492413
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发表时间：
2008-01-01
期刊：
影响因子：
8.3
通讯作者：
Dhaher, Yasin Y.
中科院分区：
文献类型：
--
作者：
Cruz, Theresa Hayes;Dhaher, Yasin Y.
背景和目的-尽管中风幸存者经常表现出异常的关节扭矩模式，但下肢扭矩耦合的研究还很缺乏，方法：22名慢性步行中风受试者和11名年龄匹配的对照受试者在偏瘫腿的额状面和矢状面产生等长髋关节扭矩（或随机选择的腿作为对照组）的姿势类似于步态的阶段。非自愿的膝关节扭矩也记录，虽然没有反馈或指示gived.Results-In脚趾关闭和midswing姿势，中风组有一个显着的扭矩偏向伸展和内收，而对照组有一个对称的扭矩空间。中风组在屈曲和外展/屈曲方向上产生的扭矩也明显小于对照组。最后，中风组显示异常耦合的膝关节伸展与髋关节内收，独特的toe-off position. Conclusions，而中风后步态异常已被归因于一些因素，包括矢状面强度损伤在髋关节，膝关节和踝关节，我们的研究结果表明，中风后的神经力学变化可能发挥重要作用，在确定运动异常的性质。具体而言，除了方向特异性髋关节扭矩无力外，还观察到髋关节内收和膝关节伸展扭矩耦合异常。未来的研究需要描绘的差异贡献的每个潜在因素步态异常。了解脑卒中后潜在的神经力学变化可能有助于制定康复策略。
Background and Purpose-Although stroke survivors often display abnormal joint torque patterns, studies of torque-coupling in the lower limb are lacking, despite their potential impact on gait abnormalities.Methods-Twenty-two chronic ambulating stroke subjects and 11 age-matched control subjects produced isometric hip torques in the frontal and sagittal planes with the hemiparetic leg (or randomly selected leg for the control group) in postures that resemble stages of gait. The involuntary knee torques were also recorded although no feedback or instructions were given.Results-In the toe-off and midswing postures, the stroke group had a significant torque bias toward extension and adduction, whereas the control group had a symmetric torque space. The stroke group also produced significantly smaller torques than the control group in the flexion and abduction/flexion directions. Finally, the stroke group displayed abnormal coupling of knee extension with hip adduction, unique to the toe-off position.Conclusions-Whereas gait abnormalities after stroke have been attributed to a number of factors, including sagittal plane strength impairments at the hip, knee, and ankle, our findings indicate that neuromechanical changes after stroke may play a significant role in determining the nature of the movement abnormality. Specifically, abnormal hip adduction and knee extension torque coupling was observed, in addition to direction-specific hip torque weakness. Future studies are needed to delineate the differential contributions of each potential factor to gait abnormalities. Understanding the underlying neuromechanical changes after stroke may aid the development of rehabilitation strategies.