{"title":"中风患者跨越障碍时的步态特征与跌倒风险之间的关系前瞻性队列研究","authors":"Xianglin Wan , Zihao Zhu , Feng Xu , Qiujie Li","doi":"10.1016/j.gaitpost.2025.03.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In daily life, stroke patients frequently experience falls during obstacle crossing. Analyzing the gait characteristics of patients in high-risk falling scenarios can help identify and predict fall risks.</div></div><div><h3>Research question</h3><div>Exploring the predictive power of gait characteristics during obstacle crossing for fall risk in stroke patients.</div></div><div><h3>Methods</h3><div>Recruitment of 38 stroke patients with unilateral hemiplegia discharged from rehabilitation. A Qualisys motion capture system and two Kistler force plates were used to record the marker positions and the ground reaction forces during crossing an obstacle 4 cm in height with the affected limb as the leading limb. Gait spatio-temporal parameters, joint angles, and joint moments were calculated. Following a 12-month follow-up survey to collect data on falls among participants, independent samples <em>t</em>-test and binary logistic regression models were employed to identify predictors associated with future fall risk.</div></div><div><h3>Results</h3><div>During the follow-up period, 13 participants experienced at least one fall and were categorized into the fall group; 14 participants did not experience any falls and were categorized into the non-fall group. Binary logistic regression analysis revealed that the toe-clearance distance of the trailing limb, as well as the peak ankle plantarflexion moment of the trailing limb during double support phase, are effective predictors of fall risk in stroke patients (<em>P</em> < 0.05). The overall correct prediction rate of the regression model incorporating both factors was 85.2 %.</div></div><div><h3>Significance</h3><div>Gait analysis during obstacle crossing holds potential clinical value in identifying future fall risk in stroke patients.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 9-16"},"PeriodicalIF":2.2000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between gait characteristics during obstacle crossing and fall risk in stroke patients: A prospective cohort study\",\"authors\":\"Xianglin Wan , Zihao Zhu , Feng Xu , Qiujie Li\",\"doi\":\"10.1016/j.gaitpost.2025.03.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>In daily life, stroke patients frequently experience falls during obstacle crossing. Analyzing the gait characteristics of patients in high-risk falling scenarios can help identify and predict fall risks.</div></div><div><h3>Research question</h3><div>Exploring the predictive power of gait characteristics during obstacle crossing for fall risk in stroke patients.</div></div><div><h3>Methods</h3><div>Recruitment of 38 stroke patients with unilateral hemiplegia discharged from rehabilitation. A Qualisys motion capture system and two Kistler force plates were used to record the marker positions and the ground reaction forces during crossing an obstacle 4 cm in height with the affected limb as the leading limb. Gait spatio-temporal parameters, joint angles, and joint moments were calculated. Following a 12-month follow-up survey to collect data on falls among participants, independent samples <em>t</em>-test and binary logistic regression models were employed to identify predictors associated with future fall risk.</div></div><div><h3>Results</h3><div>During the follow-up period, 13 participants experienced at least one fall and were categorized into the fall group; 14 participants did not experience any falls and were categorized into the non-fall group. Binary logistic regression analysis revealed that the toe-clearance distance of the trailing limb, as well as the peak ankle plantarflexion moment of the trailing limb during double support phase, are effective predictors of fall risk in stroke patients (<em>P</em> < 0.05). The overall correct prediction rate of the regression model incorporating both factors was 85.2 %.</div></div><div><h3>Significance</h3><div>Gait analysis during obstacle crossing holds potential clinical value in identifying future fall risk in stroke patients.</div></div>\",\"PeriodicalId\":12496,\"journal\":{\"name\":\"Gait & posture\",\"volume\":\"120 \",\"pages\":\"Pages 9-16\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gait & posture\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0966636225001547\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gait & posture","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966636225001547","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Association between gait characteristics during obstacle crossing and fall risk in stroke patients: A prospective cohort study
Background
In daily life, stroke patients frequently experience falls during obstacle crossing. Analyzing the gait characteristics of patients in high-risk falling scenarios can help identify and predict fall risks.
Research question
Exploring the predictive power of gait characteristics during obstacle crossing for fall risk in stroke patients.
Methods
Recruitment of 38 stroke patients with unilateral hemiplegia discharged from rehabilitation. A Qualisys motion capture system and two Kistler force plates were used to record the marker positions and the ground reaction forces during crossing an obstacle 4 cm in height with the affected limb as the leading limb. Gait spatio-temporal parameters, joint angles, and joint moments were calculated. Following a 12-month follow-up survey to collect data on falls among participants, independent samples t-test and binary logistic regression models were employed to identify predictors associated with future fall risk.
Results
During the follow-up period, 13 participants experienced at least one fall and were categorized into the fall group; 14 participants did not experience any falls and were categorized into the non-fall group. Binary logistic regression analysis revealed that the toe-clearance distance of the trailing limb, as well as the peak ankle plantarflexion moment of the trailing limb during double support phase, are effective predictors of fall risk in stroke patients (P < 0.05). The overall correct prediction rate of the regression model incorporating both factors was 85.2 %.
Significance
Gait analysis during obstacle crossing holds potential clinical value in identifying future fall risk in stroke patients.
期刊介绍:
Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance.
The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.