膝踝足矫形器的踝关节自由度对亚急性重度偏瘫患者瘫侧负荷模式和肱三头肌活动的影响:一项回顾性研究。

IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL
Ayumu Ogura, Yuta Chujo, Naoto Mano, Kimihiko Mori, Takayuki Konishi, Takayuki Kuwabara, Masanori Wakida, Kimitaka Hase
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引用次数: 0

摘要

背景:亚急性重度偏瘫患者通常会接受交替步态训练,以克服实现独立行走的挑战。然而,膝踝足矫形器(KAFO)中的踝关节设置取决于使用 KAFO 进行交替步态训练的躯干功能或瘫痪阶段。膝踝足矫形器中踝关节的最佳自由度以及有效康复所需的特定踝关节条件仍不清楚。因此,本研究旨在调查踝关节不同自由度对使用 KAFO 的瘫痪侧压力中心(CoP)参数和肌肉活动的影响,并根据身体功能调查 KAFO 中踝关节角度的推荐设置:本研究包括 14 名亚急性中风患者(67.4 ± 13.3 岁)。使用线性混合模型(LMM)比较了在 KAFO 中两种踝关节条件下的 CoP 参数以及腓肠肌外侧(GCL)和比目鱼肌的肌肉活动:固定在 0° 和踝关节自由外展。我们使用线性混合模型证实了不同条件下 CoP 参数或肌肉活动的变化与身体功能特征(如 Fugl-Meyer 下肢协同作用评估评分(FMAs)和躯干损伤量表(TIS))之间的关系:结果:与固定状态相比,在踝关节外翻的自由状态下,CoP 的前后位移(AP_CoP)(p = 0.011)和 GCL 的肌肉活动(p = 0.043)均有所增加。FMAs (p = 0.004) 和 TIS (p = 0.008) 与 AP_CoP 呈正相关。此外,还发现 TIS 与 CoP 中前脚掌内侧负重时间的百分比之间存在正相关关系(p 结论:TIS 与 CoP 中前脚掌内侧负重时间的百分比之间存在正相关关系:对于重度亚急性偏瘫患者,KAFO 中的踝关节外展诱导不会阻碍小腿的前倾,可促进 CoP 的前移和 GCL 的肌肉活动。这项研究表明,根据身体功能的改善情况调整 KAFO 中踝关节的背屈活动度可促进 CoP 向前脚内侧加载。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of ankle joint degree of freedom of knee-ankle-foot orthoses on loading patterns and triceps surae muscle activity on the paretic side in individuals with subacute severe hemiplegia: a retrospective study.

Background: Individuals with subacute severe hemiplegia often undergo alternate gait training to overcome challenges in achieving walking independence. However, the ankle joint setting in a knee-ankle-foot orthosis (KAFO) depends on trunk function or paralysis stage for alternate gait training with a KAFO. The optimal degree of ankle joint freedom in a KAFO and the specific ankle joint conditions for effective rehabilitation remain unclear. Therefore, this study aimed to investigate the effects of different degrees of freedom of the ankle joint on center-of-pressure (CoP) parameters and muscle activity on the paretic side using a KAFO and to investigate the recommended setting of ankle joint angle in a KAFO depending on physical function.

Methods: This study included 14 participants with subacute stroke (67.4 ± 13.3 years). The CoP parameters and muscle activity of the gastrocnemius lateralis (GCL) and soleus muscles were compared using a linear mixed model (LMM) under two ankle joint conditions in the KAFO: fixed at 0° and free ankle dorsiflexion. We confirmed the relationship between changes in CoP parameters or muscle activity under different conditions and physical functional characteristics such as the Fugl-Meyer Assessment of Lower Extremity Synergy Score (FMAs) and Trunk Impairment Scale (TIS) using LMM.

Results: Anterior-posterior displacement of CoP (AP_CoP) (p = 0.011) and muscle activity of the GCL (p = 0.043) increased in the free condition of ankle dorsiflexion compared with that in the fixed condition. The FMAs (p = 0.004) and TIS (p = 0.008) demonstrated a positive relationship with AP_CoP. A positive relationship was also found between TIS and the percentage of medial forefoot loading time in the CoP (p < 0.001).

Conclusions: For individuals with severe subacute hemiplegia, the ankle dorsiflexion induction in the KAFO, which did not impede the forward tilt of the shank, promotes anterior movement in the CoP and muscle activity of the GCL. This study suggests that adjusting the dorsiflexion mobility of the ankle joint in the KAFO according to improvement in physical function promotes loading of the CoP to the medial forefoot.

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来源期刊
Journal of NeuroEngineering and Rehabilitation
Journal of NeuroEngineering and Rehabilitation 工程技术-工程:生物医学
CiteScore
9.60
自引率
3.90%
发文量
122
审稿时长
24 months
期刊介绍: Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.
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