刘丽玲，倪朝民，岳童，刘孟，刘郑，陈进，张金龙，庄建海.脑卒中偏瘫患者步行时足底压力中心的特点[J].中华物理医学与康复杂志,2015,37(11):830-834
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| 脑卒中偏瘫患者步行时足底压力中心的特点 |
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| DOI： |
| 中文关键词: 脑卒中 步态障碍，神经性 足底压力中心 步速 步态不对称性 |
| 英文关键词: Stroke Gait disorders, neurologic Center of pressure Walking speed Gait asymmetry |
| 基金项目:安徽省科技厅年度重点科研项目(11070403064) |
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| 中文摘要: |
| 目的探讨脑卒中偏瘫患者步行时足底压力中心（COP）相关参数的特点及其与步速、不对称性的相关性。 方法选取60例能够独立步行的脑卒中偏瘫患者（偏瘫组）及健康中老年人（对照组），每组30例，2组受试者均以自我选择的步速进行步态测试，提取并计算步速及两侧下肢的单支撑时间、双支撑时间、单支撑期COP在前后方向的位移（AP-COPDS）及其速度(AP-COPVS)、双支撑期COP在前后方向的位移（AP-COPDD）及其速度（AP-COPVD），以及单支撑时间对称性比等参数，并分析和比较COP相关参数及其与步速、不对称性的相关程度。 结果对照组和偏瘫组的步速分别为（73.60±9.66）和（37.88±16.01）cm/s，偏瘫组步速较对照组明显下降（P<0.01）。偏瘫侧单支撑时间［（0.39±0.07）s］较对照组［（0.44±0.04）s］明显缩短（P<0.01）；非偏瘫侧的单支撑时间［（0.53±0.12）s］及两侧双支撑时间［（0.36±0.15）s、（0.36±0.21）s］均较对照组［（0.44±0.04）s及（0.15±0.03）s］延长（P<0.01）；偏瘫组患者两侧下肢所有COP相关参数均较对照组减小，且差异均有统计学意义（P<0.01）。偏瘫组两侧下肢所有COP相关参数均与步速呈高度正相关（r=0.765～0.967，P<0.01）；所有COP相关参数与单支撑时间对称性比呈不同程度正相关（r=0.505～0.764，P<0.01）。 结论脑卒中偏瘫患者步行时，足底负重在前后方向转移的能力下降，且与步速、单支撑时间对称性比呈正相关。 |
| 英文摘要: |
| Objective To explore the gait characteristics of hemiplegic stroke survivors related to center of pressure (COP) and their correlation with velocity and gait asymmetry. MethodsThirty hemiplegic stroke survivors who could walk at least 10 metres were recruited as the experimental group and thirty healthy elderly persons as the control group. All of the participants were asked to walk along a pressure-sensitive mat. Single support time, double support time, anterior-posterior (AP) COP displacement during the single-support phase (AP-COPDS), AP-COP velocity during the single-support phase (AP-COPVS), AP-COPD during the double-support phase (AP-COPDD), AP-COPV during the double-support phase (AP-COPVD) and the single-support-time symmetry ratio were all recorded. Student′s t test was used to compare these data between the two groups. Pearson correlation coefficients were computed to assess any correlation with velocity and the single-support-time symmetry ratio. ResultsAmong the control group there was no significant difference in any of the observations between their two limbs. Compared with the control group, the experimental group had shorter single support times for the paretic limb and prolonged single support time for the non-paretic limb. They also showed prolonged double support time, shorter AP-COPDS and AP-COPDD, and slower AP-COPVS and AP-COPVD for both limbs. The differences were all significant. All the COP-related parameters were positively correlated with velocity and the single-support-time symmetry ratio. ConclusionsHemiplegia impairs the ability to transfer load from one foot to the other. Improving that ability can help increase walking speed and improve gait symmetry. COP-related variables can provide useful references in gait evaluation and the rehabilitation of hemiplegic patients following stroke. |
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