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Cognitive status and sleep quality can explain the fear of falling and fall history in people with Parkinson's disease. 认知状态和睡眠质量可以解释帕金森病患者对跌倒的恐惧和跌倒史。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-08-15 DOI: 10.1097/MRR.0000000000000596
Nesreen Alissa, Reem Rehan, Alham Al-Sharman, Mariem Latrous, Ala' S Aburub, Khalid El-Salem, Linzette Morris, Hanan Khalil

Fear of falling (FOF) is highly prevalent in people with Parkinson's disease (PwPD) and contributes to high fall risk. Studies reporting on the relationship between falls, FOF, and non-motor factors such as cognitive function and sleep quality in Parkinson's disease are limited. This study aimed to investigate (1) the relationship of cognitive function and sleep quality with FOF, and history of falls in PwPD; (2) differences in cognitive function and sleep quality between Parkinson's disease fallers and non-fallers; and (3) a cut-off score for cognitive function and sleep quality to discriminate Parkinson's disease fallers from non-fallers. Fifty PwPD were assessed for FOF [Falls Efficacy Scale-International (FES-I)], cognition [Montréal Cognitive Assessment (MOCA)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and falls history. The MOCA is significantly associated with FES-I scores ( R2  = 0.429, P  < 0.0001). Both MOCA ( P  = 0.012) and PSQI ( P  = 0.027) were associated with falls history even after adjusting for confounding factors (age, sex, L-dopa use, Parkinson's disease severity). Both MOCA and PSQI scores were able to distinguish fallers from non-fallers with cut-off scores of 15.5 and 7.5, respectively. Although our findings revealed that both cognitive function and sleep quality are important factors influencing falls and FOF in PwPD, it remains to be determined if addressing cognitive impairments and poor sleep quality may favorably impact balance before integrating such screenings into fall prevention programs.

对跌倒的恐惧(FOF)在帕金森病(PwPD)患者中非常普遍,并导致高跌倒风险。关于帕金森病患者跌倒、FOF和认知功能和睡眠质量等非运动因素之间关系的研究报道有限。本研究旨在探讨(1)认知功能和睡眠质量与PwPD患者FOF和跌倒史的关系;(2) 帕金森病跌倒者和非跌倒者认知功能和睡眠质量的差异;以及(3)认知功能和睡眠质量的临界分数,以区分帕金森病患者和非患者。对50名PwPD进行了FOF[国际跌倒疗效量表(FES-I)]、认知[蒙特利尔认知评估(MOCA)]、睡眠质量[匹兹堡睡眠质量指数(PSQI)]和跌倒史评估。MOCA与FES-I评分显著相关(R2 = 0.429,P
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引用次数: 0
Reproducibility and content validity of the Slovenian version of the STarT Back Screening Tool for chronicity risk assessment in patients with low back pain. 斯洛文尼亚版STarT背部筛查工具用于腰痛患者慢性风险评估的可重复性和内容有效性。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-10-16 DOI: 10.1097/MRR.0000000000000604
Marinka Cimerman, Alan Kacin

Chronic pain is the most common cause of impaired work ability and thus represents a significant social and economic burden. STarT Back Screening Tool (SBT) is the most often used screening tool for rapid identification and classification of patients for their risk of development of chronic low back pain, which is valid and reliable in the original English version and translation into other languages. The aim of the present study was to translate the SBT into Slovenian and to evaluate its content validity and reliability. We translated the SBT from English into Slovenian and back according to the standard protocol. We tested its metric properties on a group of patients with low back pain aged 18 to 65 years. The reliability of the reassessment was calculated using the ICC and specific agreement, while the content validity of the questionnaire was determined using the ceiling and floor effect. Of the 42 patients who participated in the study, 42.9% were at low risk, 33.3% were at moderate risk, and 23.8% were at high risk of developing chronic pain, according to the SBT. The ICC for the entire sample was 0.96 (95% CI 0.92-0.98). The Slovenian translation of the SBT showed excellent specific agreement between the initial and repeat assessments: 91.4% for the low-risk group, 85.7% for the moderate-risk group, and 95.2% for the high-risk group. In addition, it showed good content validity, as no ceiling or floor effects were detected. The Slovenian translation of the questionnaire is suitable for clinical use.

慢性疼痛是工作能力受损的最常见原因,因此是一种重大的社会和经济负担。STarT背部筛查工具(SBT)是最常用的筛查工具,用于快速识别和分类患者患慢性腰痛的风险,其英文原版和翻译成其他语言都是有效和可靠的。本研究的目的是将SBT翻译成斯洛文尼亚语,并评估其内容的有效性和可靠性。我们根据标准协议将SBT从英语翻译成斯洛文尼亚语并返回。我们在一组18至65岁的腰痛患者身上测试了它的度量特性。使用ICC和具体协议计算重新评估的可靠性,而使用上限和下限效应确定问卷的内容有效性。根据SBT,在参与研究的42名患者中,42.9%的患者处于低风险,33.3%的患者处于中风险,23.8%的患者处于慢性疼痛的高风险。整个样本的ICC为0.96(95%CI 0.92-0.98)。SBT的斯洛文尼亚语翻译在初始和重复评估之间显示出极好的特异性一致性:低风险组为91.4%,中风险组为85.7%,高风险组为95.2%。此外,由于没有检测到天花板或地板效应,它显示出良好的内容有效性。调查表的斯洛文尼亚语译文适合临床使用。
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引用次数: 0
Clinimetric evaluation of five clinically feasible measures of the leg extensor muscle strength in neurological rehabilitation settings. 神经康复环境中五种临床可行的腿部伸肌力量测量方法的临床评估。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-07-11 DOI: 10.1097/MRR.0000000000000594
Edwina J Sutherland, Michelle B Kahn, Gavin P Williams

A gold-standard clinical measure of leg muscle strength has not been established. Therefore, the aim of this study was to evaluate clinimetric properties of five clinically feasible measures of lower-limb extensor muscle strength in neurological rehabilitation settings. This was a cross-sectional observational study of 36 participants with leg weakness as a result of a neurological condition/injury. Participants were recruited across a range of walking abilities, from non- to independently ambulant. Each was assessed using each of the following five measures: manual muscle test (MMT), hand-held dynamometry (HHD), seated single leg press one repetition maximum (1RM), functional sit-to-stand (STS) test and seated single leg press measured with a load cell. Each clinical measure was evaluated for its discriminative ability, floor/ceiling effects, test-retest reliability and clinical utility. The load cell and HHD were the most discriminative of the tests and were also resistant to floor/ceiling effects; however, the load cell was superior to the HHD when compared for its clinical utility. The MMT/STS tests received perfect scores for clinical utility, although similar to the 1RM test, they were susceptible to floor and ceiling effects. The load cell leg press test was the only measure of lower limb strength to satisfy all four clinimetric properties. Implications for clinical practice include, firstly, that strength tests available to clinicians vary in their clinimetric properties. Secondly, the functional status of the person will determine selection of the best clinical strength test. And lastly, load cell device technology should be considered for clinical strength assessments.

腿部肌肉力量的金标准临床测量尚未建立。因此,本研究的目的是评估神经康复环境中五种临床可行的下肢伸肌力量测量方法的临床特性。这是一项针对36名因神经系统疾病/损伤而出现腿部无力的参与者的横断面观察性研究。参与者被招募到一系列的行走能力,从非行走能力到独立行走能力。使用以下五种测量方法中的每一种进行评估:手动肌肉测试(MMT)、手持式测力仪(HHD)、最大重复一次的坐姿单腿按压(1RM)、功能性坐立式(STS)测试和用称重传感器测量的坐姿单脚按压。评估每项临床测量的辨别能力、下限/上限效应、重测可靠性和临床实用性。称重传感器和HHD是最具鉴别力的测试,也能抵抗地板/天花板的影响;然而,就其临床实用性而言,称重传感器优于HHD。MMT/STS测试在临床实用性方面获得了完美的分数,尽管与1RM测试类似,它们容易受到地板和天花板效应的影响。测压元件腿部压力测试是唯一能满足所有四种临床特性的下肢强度测量方法。对临床实践的影响包括,首先,临床医生可以使用的强度测试在其临床特性上各不相同。其次,患者的功能状态将决定最佳临床力量测试的选择。最后,称重传感器设备技术应被考虑用于临床强度评估。
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引用次数: 0
Discharge outcomes as predictors of social participation in the community after a stroke: a cohort study. 出院结果作为卒中后社区社会参与的预测因素:一项队列研究。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-08-03 DOI: 10.1097/MRR.0000000000000599
Flaviane Ribeiro de Souza, Matheus Sales, Larrie Rabelo Laporte, Ailton Melo, Nildo Manoel da Silva Ribeiro

The mapping of possible predictors of restrictions in the social participation of people after stroke in the community can be an essential tool to support the development of rehabilitation strategies even in the hospital environment. This study aimed to identify whether mobility, functional balance and dependence on functionality at hospital discharge can predict restrictions on social participation 1 year after stroke in the community. This is a hospital-based cohort study, with individuals over 18 years old admitted with a diagnosis of acute stroke included. People with dementia, previous functional limitations and cancer patients were omitted. Mobility, balance and functional independence were the predictor variables at hospital discharge, and the outcome of interest was social participation assessed 1 year after a stroke in the community. Forty-eight patients were included after a 1-year follow-up. The degree of functional independence at hospital discharge ( β  = 0.813; P  < 0.01) was the independent predictor of social participation, specifically the locomotion ( β  = 0.452; P  < 0.001) and social cognition ( β  = 0.462; P  < 0.001) related to functional independence. Mobility ( β  = 0.040; P  = 0.777) and functional balance ( β  = 0.060; P  = 0.652) did not show an independent association. Cognitive functional independence was a predictor of daily activities ( β  = 0.786; P  < 0.001), social roles ( β  = 0.390; P  = 0.014) and satisfaction ( β  = 0.564; P  < 0.001) of social participation. The degree of functional independence of people after a stroke at hospital discharge was able to predict the level of social involvement in the community one year after the stroke.

绘制中风患者在社区中社会参与限制的可能预测因素,即使在医院环境中,也可以成为支持康复策略制定的重要工具。这项研究旨在确定出院时的行动能力、功能平衡和对功能的依赖是否可以预测社会参与的限制1 社区中风后一年。这是一项基于医院的队列研究,研究对象为18岁以上的人 岁,诊断为急性中风。痴呆症患者、既往功能受限患者和癌症患者被忽略。流动性、平衡性和功能独立性是出院时的预测变量,感兴趣的结果是社会参与评估1 社区中风一年后。48名患者在一年的随访后被纳入。出院时的功能独立程度(β = 0.813;P
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引用次数: 0
Reliability and validity of the T-shirt test for the assessment of unsupported sitting in manual wheelchair users with spinal cord injury. T恤测试用于评估无支撑坐在手动轮椅使用者脊髓损伤的可靠性和有效性。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-08-15 DOI: 10.1097/MRR.0000000000000600
Francielle Romanini, Rafaella M Zambetta, Natália Padula, Roberta C Gaspar, Thiago L Russo, Jocemar Ilha

This study aimed to evaluate the validity and reliability of the T-shirt test (TST) in assessing sitting stability under three thigh support conditions and with timed outcomes derived in six ways among individuals with a spinal cord injury (SCI). The TST was performed five times under three thigh support conditions (85%, 55% and 25% of total thigh length) in two evaluations spaced between 7-14 days. For each thigh condition, six different outcomes were derived (average or best time from 2, 3, and 5 trial). All outcomes derivation showed excellent reliability on test day (intraclass correlation coefficient; ICC  ≥ 0.997) and excellent test-retest reliability (ICC ≥ 0.874) for each thigh support condition. The TST showed high inverse correlations with the Spinal Cord Independence Measure III (SCIM)-mobility score for all outcomes and support conditions (ρ≥-0.706), except for Best-5; moderate inverse correlations with total SCIM-total scores for most outcome derivations and support conditions (ρ≥-0.636); and a moderate inverse correlation with confidence and capacity domains of Wheelchair Skills Test-Questionnaire for most outcome derivation and support conditions (ρ≥-0.504). The TST could discriminate cervical from high and low thoracic levels of injuries under minimal thigh support condition. Overall, all the TST-derived outcomes and support conditions showed adequate validity and test-retest reliability, but Best-5 had inconsistency. Under the minimal thigh support condition, all outcome derivations except Best-3 could discriminate cervical from other injury-level groups. Although all outcome derivations and thigh support conditions provided reliable results, we recommend using the average of 3 trials under the maximal thigh support condition.

本研究旨在评估T恤测试(TST)在评估三种大腿支撑条件下的坐姿稳定性方面的有效性和可靠性,并通过六种方式得出脊髓损伤(SCI)患者的时间结果。在间隔7-14天的两次评估中,在三种大腿支撑条件下(占大腿总长度的85%、55%和25%)进行了五次TST。对于每种大腿状况,得出六种不同的结果(2、3和5次试验的平均或最佳时间)。所有结果推导在测试日显示出良好的可靠性(组内相关系数;ICC ≥ 0.997)和良好的重测可靠性(ICC ≥ 0.874)。除Best-5外,TST与所有结果和支持条件下的脊髓独立性测量III(SCIM)-活动性评分呈高度负相关(ρ≥-0.706);在大多数结果推导和支持条件下,与SCIM总分呈中度负相关(ρ≥-0.636);在大多数结果推导和支持条件下,与轮椅技能测试问卷的置信度和能力域呈中度负相关(ρ≥-0.504)。TST可以在最小大腿支持条件下区分颈部和胸部的损伤程度。总体而言,所有TST得出的结果和支持条件都显示出足够的有效性和重新测试的可靠性,但Best-5存在不一致性。在最小大腿支撑条件下,除Best-3外的所有结果推导都可以区分宫颈损伤和其他损伤水平组。尽管所有结果推导和大腿支撑条件都提供了可靠的结果,但我们建议在最大大腿支撑条件下使用3次试验的平均值。
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引用次数: 0
Time to say goodbye. 是时候说再见了。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-09-21 DOI: 10.1097/MRR.0000000000000603
Črt Marinček
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引用次数: 0
The effectiveness of home-based therapeutic exercises on adults with fibromyalgia: a systematic review and meta-analysis. 家庭治疗性锻炼对成人纤维肌痛的有效性:一项系统综述和荟萃分析。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-10-31 DOI: 10.1097/MRR.0000000000000606
Esra' Saleh, Mohammad A Yabroudi, Mohammad Al-Wardat, Zakariya H Nawasreh, Khader Almhdawi, Mohammad Etoom

The objective of this systematic review and meta-analysis is to evaluate the effectiveness of home-based exercises (HBE) in alleviating pain, fatigue, depression, and anxiety and enhancing the quality of life (QOL) among adults with fibromyalgia. A comprehensive search was conducted across four databases PubMed, Cochrane, CINAHL (EBSCO), and PEDro to identify eligible randomized controlled trials (RCTs). Standardized mean differences (SMDs) at a 95% confidence interval (CI) were computed. Ten RCTs met the inclusion criteria, involving 601 participants, with a good-to-fair quality according to the PEDro scale. Of the 10 included studies, 3 compared HBE to no exercise, while 7 compared HBE to center-based exercises (CBE). HBE showed significant pain reduction (SMD = 0.775, P = 0.003) and improved QOL as measured by the fibromyalgia impact questionnaire (FIQ) (SMD = 0.621, P = 0.001) compared with no exercise, but there were no significant differences in depression and QOL as measured by SF-36 compared with CBE. In contrast, CBE demonstrated greater pain reduction (SMD = -1.325, P < 0.001) and improved FIQ scores (SMD = -0.843, P = 0.017) compared with HBE. In conclusion, HBE exhibit effectiveness in alleviating pain, and depression and enhancing QOL among fibromyalgia patients in comparison to no exercise. However, CBE are more effective in reducing pain and enhancing QOL than HBE, although HBE can be valuable for maintaining activity levels in fibromyalgia patients between treatment cycles.

本系统综述和荟萃分析的目的是评估家庭锻炼(HBE)在减轻成人纤维肌痛患者的疼痛、疲劳、抑郁和焦虑以及提高生活质量(QOL)方面的有效性。在PubMed、Cochrane、CINAHL(EBSCO)和PEDro四个数据库中进行了全面搜索,以确定符合条件的随机对照试验(RCT)。计算95%置信区间(CI)下的标准化平均差(SMD)。10项随机对照试验符合入选标准,涉及601名参与者,根据PEDro量表,质量良好至尚可。在纳入的10项研究中,3项将HBE与不锻炼进行了比较,7项将HBE与中心锻炼(CBE)进行了比较。与不运动相比,HBE显示出显著的疼痛减轻(SMD=0.775,P=0.003)和纤维肌痛影响问卷(FIQ)测量的生活质量改善(SMD=0.621,P=0.001),但与CBE相比,SF-36测量的抑郁和生活质量没有显著差异。相反,与HBE相比,CBE表现出更大的疼痛减轻(SMD=-1.325,P<0.001)和FIQ评分改善(SMD=-0.843,P=0.017)。总之,与不运动相比,HBE在减轻纤维肌痛患者的疼痛、抑郁和提高生活质量方面表现出有效性。然而,CBE在减轻疼痛和提高生活质量方面比HBE更有效,尽管HBE对于在治疗周期之间维持纤维肌痛患者的活动水平是有价值的。
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引用次数: 0
Addition of backward walking training to forward walking training improves walking speed in children with cerebral palsy: a systematic review with meta-analysis. 将后向行走训练与前向行走训练相结合可提高脑瘫儿童的行走速度:一项荟萃分析系统综述。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-08-15 DOI: 10.1097/MRR.0000000000000598
Kênia K P Menezes, Patrick R Avelino, Lucas R Nascimento

The objective was to examine the effects of backward walking training for improving walking speed and balance in children with cerebral palsy. A systematic review of randomized trials was conducted. Trials had to include children with cerebral palsy, with a Gross Motor Function Classification System, between I and III, that delivered backward walking training as a solo intervention or in combination with forward walking training. The outcomes of interest were walking speed and balance. The methodological quality of included trials was assessed by the PEDro scale, and the quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight papers, involving 156 participants, were included. Using random-effects meta-analysis, we estimated that backward walking training improved walking speed by 0.10 m/s [95% confidence interval (CI) 0.05-0.16] and by 2 points on the Pediatric Balance Scale (0-56) (95% CI 1.5-2.2) more than forward walking training. We also estimated that the addition of backward walking training increased walking speed by 0.20 m/s (95% CI 0.07-0.34) and reduced the angular excursion of the center of gravity by 0.5 degrees (95% CI -0.7 to -0.3). The quality of the evidence was classified as low to moderate. In conclusion, overall, backward walking training appears to be as effective or slightly superior to forward walking training for improving walking speed in children with CP. The addition of backward walking training statistically significantly and clinically important enhanced benefits on walking speed.

目的是检验后向步行训练对改善脑瘫儿童步行速度和平衡的效果。对随机试验进行了系统回顾。试验必须包括患有脑瘫的儿童,该儿童的毛运动功能分类系统在I至III之间,将向后行走训练作为单独干预或与向前行走训练相结合。感兴趣的结果是行走速度和平衡。纳入试验的方法学质量通过PEDro量表进行评估,证据质量根据建议评估、开发和评估分级进行评估。共有8篇论文,涉及156名参与者。使用随机效应荟萃分析,我们估计后向步行训练使步行速度提高了0.10 m/s[95%置信区间(CI)0.05-0.16],并且在儿科平衡量表(0-56)(95%CI 1.5-2.2)上比向前步行训练多2分。我们还估计,后向步行训练的增加使步行速度增加了0.20 m/s(95%CI 0.07-0.34),并将重心的角偏移减少0.5 证据质量分为低至中等。总之,总的来说,在改善脑瘫儿童的步行速度方面,后向步行训练似乎与前向步行训练一样有效或略好。后向步行培训的加入在统计学上显著且具有临床意义,增强了对步行速度的益处。
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引用次数: 0
Predictors of manual dexterity at 3 and 6 months after stroke: integration of clinical, neurophysiological, and neuroimaging factors. 卒中后3个月和6个月手巧的预测因素:临床、神经生理学和神经影像学因素的整合。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-09-05 DOI: 10.1097/MRR.0000000000000601
Eui Jin Jeong, Mun Jeong Kang, Sekwang Lee, Yeji Hwang, Ju Seob Park, Ki Min Kim, Sung-Bom Pyun

This retrospective study aimed to predict dexterity at 3 and 6 months post-stroke by integrating clinical, neurophysiological, and neuroimaging factors. We included 126 patients with first-ever, unilateral, and supratentorial stroke. Demographic, stroke characteristics, and initial clinical assessment variables [Mini-mental state examination and Fugl-Meyer Assessment Upper Extremity (FMA-UE)] were evaluated 2 weeks after stroke. Dexterity, measured using the Manual Function Test (MFT) hand subscore, was the primary outcome. The neurophysiological variables, upper limb somatosensory evoked potential (SEP) and motor evoked potential (MEP), were assessed 2 weeks post-stroke. The neuroimaging variable, fractional anisotropy (FA) of the corticospinal tract (CST), was assessed 3 weeks post-stroke. Multiple regression analysis revealed significant predictors for improved dexterity at 3 and 6 months post-stroke, including younger age, higher FMA-UE score, presence of waveforms in the SEP and MEP, and higher FA values in the CST (adjusted R 2  = 0.776, P  < 0.001 at 3 months; adjusted R 2  = 0.668, P  < 0.001 at 6 months; where MEP, SEP, and FA accounted together for an additional 0.079 and 0.166 of variance beyond age and FMA-UE, respectively). Subgroup analysis was conducted by categorizing the participants based on their initial hand function: those with no hand function (MFT hand subscore = 0) (N = 60) and those with a score >0 (N = 51). Initial FMA-UE was a primary predictive factor regardless of the time point or initial severity, whereas the presence of MEP was a significant predictor only in the group with no initial hand dexterity.

这项回顾性研究旨在通过整合临床、神经生理学和神经影像学因素来预测卒中后3个月和6个月的灵活性。我们纳入了126例首次、单侧和幕上卒中患者。在卒中后2周评估人口统计学、卒中特征和初始临床评估变量[迷你精神状态检查和Fugl-Meyer上肢评估(FMA-UE)]。使用手动功能测试(MFT)手分量表测量的灵活性是主要结果。脑卒中后2周评估神经生理学变量,上肢体感诱发电位(SEP)和运动诱发电位(MEP)。脑卒中后3周评估神经影像学变量,皮质脊髓束各向异性分数(FA)。多元回归分析显示,卒中后3个月和6个月灵活性改善的显著预测因素,包括年龄更小、FMA-UE评分更高、SEP和MEP中存在波形以及CST中FA值更高(调整R2 = 0.776,P 0(N = 51)。无论时间点或初始严重程度如何,初始FMA-UE都是主要的预测因素,而MEP的存在仅在没有初始手灵活性的组中是一个重要的预测因素。
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引用次数: 0
Effects of ankle-foot orthosis on gait pattern and spatiotemporal indices during treadmill walking in hemiparetic stroke. 踝足矫形器对偏瘫脑卒中平板行走步态模式和时空指标的影响。
IF 1.7 4区 医学 Q3 REHABILITATION Pub Date : 2023-12-01 Epub Date: 2023-09-22 DOI: 10.1097/MRR.0000000000000602
Kei Ohtsuka, Masahiko Mukaino, Junya Yamada, Matsuda Fumihiro, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Eiichi Saitoh, Yohei Otaka

Ankle-foot orthosis (AFO) is known to correct abnormal gait patterns and improve walking stability and speed in patients with hemiparesis. To quantify these benefits in post-stroke gait, a three-dimensional motion analysis of gait pattern was conducted. Forty patients with hemiparesis were enrolled. A three-dimensional motion analysis system was used to analyze patients' treadmill walking with/without an AFO. Outcome measures were 12 abnormal gait indices (forefoot contact, knee extensor thrust, retropulsion of the hip, flexed-knee gait, medial whip in the stance phase, circumduction gait, hip hiking, insufficient knee flexion during the swing phase, excessive lateral shifting of the trunk, contralateral vaulting, excessive hip external rotation, and posterior pelvic tilt), calculated using kinematic data and spatiotemporal indices, and the symmetry index of double-stance and single-stance time and step length. Forefoot contact (without AFO vs. with AFO: 71.0 vs. 65.8, P < 0.001), circumduction gait (65.0 vs. 57.9, P < 0.001), and contralateral vaulting (78.2 vs. 72.2, P = 0.003) were significantly reduced, whereas excessive hip external rotation (53.7 vs. 62.8, P = 0.003) significantly increased during walking with an AFO. Hip hiking (77.1 vs. 71.7) showed marginal reduction with the use of AFO ( P = 0.096). The absolute symmetry index of double-stance time (21.9 vs. 16.1, P = 0.014) significantly decreased during walking with an AFO. AFO effectively mitigates abnormal gait patterns typical of hemiparetic gait. A 3D motion analysis system with clinically oriented indices can help assess intervention efficacy for gait abnormalities.

踝足矫形器(AFO)可以纠正偏瘫患者的异常步态模式,提高行走稳定性和速度。为了量化中风后步态的这些益处,对步态模式进行了三维运动分析。入选了40名偏瘫患者。使用三维运动分析系统来分析患者在有/没有AFO的情况下在跑步机上行走的情况。结果测量为12项异常步态指标(前掌接触、膝关节伸肌推力、髋关节后冲、膝关节屈曲步态、站立阶段的内侧鞭状步态、回旋步态、髋关节抬高、摆动阶段的膝关节屈曲不足、躯干过度侧移、对侧跳跃、髋关节过度外旋和骨盆后倾),利用运动学数据和时空指标计算,以及双站和单站时间和步长的对称性指标。前脚接触(无AFO与有AFO相比:71.0 vs.65.8,P<0.001)、回旋步态(65.0 vs.57.9,P<001)和对侧跳马(78.2 vs.72.2,P=0.003)显著减少,而在有AFO的行走过程中,过度的髋关节外旋(53.7 vs.62.8,P=0.005)显著增加。髋关节徒步(77.1 vs.71.7)随着AFO的使用而略有减少(P=0.096)。在使用AFO的步行过程中,双站时间的绝对对称指数(21.9 vs.16.1,P=0.014)显著降低。AFO有效地缓解了典型的偏瘫步态的异常步态模式。具有临床导向指标的3D运动分析系统可以帮助评估步态异常的干预效果。
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International Journal of Rehabilitation Research
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