Analysis of movements involved in raising lower garments during toileting in patients with stroke and hemiplegia: An analysis focused on manipulation on the paretic side

IF 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL Clinical Biomechanics Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI:10.1016/j.clinbiomech.2024.106364
Yuki Kuroda , Naoyuki Motojima , Sumiko Yamamoto
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Abstract

Background

Movements to raise lower garments in patients with stroke and hemiplegia consist of downward reach, non-paretic-side manipulation, and paretic-side manipulation. In this study, we focused on paretic-side manipulation, which is particularly difficult, and investigated the factors that make it challenging.

Methods

Forty-eight patients with stroke and hemiplegia (23 and 25 patients in independent and dependent groups, respectively) participated in this study. First, we investigated the difficulty of each manipulation using a visual analog scale to confirm the usefulness of focusing on paretic-side manipulation. Characteristics of the paretic side manipulation were compared between the dependent and independent groups using a three-dimensional motion analysis system.

Findings

The dependent group showed greater difficulty in manipulation on the paretic side compared to manipulation on the non-paretic side. The dependent group had a lower paretic limb loading ratio (p < 0.01), greater pelvic rotation angle (p < 0.01), and longer paretic side manipulation time (p < 0.01) than those in the independent group.

Interpretation

The factors that contributed to greater difficulty in manipulating the paretic side were a lower limb loading rate and larger pelvic rotation angle toward the paretic side. These factors make it difficult to reach the lower garment and result in inefficient manipulation of the paretic side.
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分析中风偏瘫患者在如厕时抬起下身衣物的动作:重点分析瘫痪侧的操作。
背景:脑卒中和偏瘫患者提升下衣的动作包括向下伸手、非瘫痪侧操作和瘫痪侧操作。在本研究中,我们重点研究了特别困难的瘫痪侧操作,并调查了使其具有挑战性的因素:方法:48 名脑卒中和偏瘫患者(独立组和依赖组分别有 23 名和 25 名患者)参加了本研究。首先,我们使用视觉类比量表调查了每种操作的难度,以确认侧重于瘫痪侧操作是否有用。利用三维运动分析系统比较了依赖组和独立组的瘫痪侧操作特点:结果:与在非瘫痪侧进行操作相比,依赖组在瘫痪侧进行操作的难度更大。依赖组的瘫痪肢体负荷率较低(p 解释: 依赖组的瘫痪肢体负荷率较高,而独立组的瘫痪肢体负荷率较低:导致瘫痪侧操作难度增加的因素是较低的肢体负荷率和向瘫痪侧较大的骨盆旋转角度。这些因素导致难以触及下部衣物,并导致对瘫痪侧的操作效率低下。
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来源期刊
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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