获得性脑损伤后无支撑行走时的体位调整：一种新测量方法的应用

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2025-05-09 DOI:10.1016/j.gaitpost.2025.05.003

Jack A. Beard , Gavin Williams , Benjamin F. Mentiplay , Simon J. Mills , Michelle Kahn

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引用次数: 0

摘要

背景：后天性脑损伤（ABI）后通常会出现体位调整受损，而体位调整的改善与ABI后前活动阶段（即坐着和站立）的活动能力恢复有关。目前尚不清楚这种关联是否存在于步行中。研究问题本研究旨在；i)确定先前在坐姿和站立时验证的姿势对齐和分散（PAD）评分是否可以应用于量化ABI患者步行时的姿势对齐，ii) PAD是否区分自选步行速度较慢和较快的人群。方法对42例ABI后行动受限的成人（可独立行走10 m）和34例健康对照（hc）以自行选择的步行速度进行三维步态分析。结果测量为PAD评分（全身姿势对齐）、步行速度（m/s）、外侧质心位移（动态姿势控制）和步态特征评分（步行质量）。结果测量评估组间差异（t检验和Cohen 's d效应大小）和个体异常发生率。结果ABI患者的PAD评分明显高于hcc患者(p <； 0.05；ES祝辞0.49)。在ABI队列中，PAD评分在两个更受影响的人群中无显著差异(p >； 0.05；ES 0.37)，影响较小(p >； 0.05；较快步行者（≥0.8 m/s）与较慢步行者(<； 0.8 m / s)。相比之下，行走速度较慢的参与者的动态姿势控制和行走质量明显较差(p <； 0.01；ES祝辞0.80)。异常的患病率很低，在下肢PAD评分中受影响较大和受影响较小的参与者中分别占19% %和26% %。初步证据表明，ABI患者行走时体位对齐可能受损。在ABI队列中，PAD没有区分较慢或较快的步行者。需要进一步的研究来确定步行时测量姿势对齐的最佳方法。

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Postural alignment during unsupported walking following acquired brain injury: Application of a new measure

Background

Impaired postural alignment is commonly observed following acquired brain injury (ABI), and improved postural alignment is associated with mobility recovery in the pre-ambulant phase (i.e. sitting and standing) following ABI. It is unknown whether this association exists for walking.

Research questions

This study aimed to; i) determine whether the postural alignment and dispersion (PAD) score, previously validated in sitting and standing, can be applied to quantify postural alignment during walking in people with ABI, and ii) whether the PAD discriminates those with slower and faster self-selected walking speed.

Methods

Forty-two adults with mobility limitations following ABI, who could walk without assistance for 10 m, and 34 healthy controls (HCs) underwent three-dimensional gait analysis at their self-selected walking speed. Outcome measures were the PAD score (whole-body postural alignment), walking speed (m/s), lateral centre of mass displacement (dynamic postural control), and the Gait Profile Score (walking quality). Outcome measures were evaluated for between-group differences (t-tests and Cohen’s d effect size) and individual incidence of abnormality.

Results

Adults with ABI had significantly higher PAD scores compared to HCs (p < 0.05; ES > 0.49). Within the ABI cohort, PAD scores were not significantly different at both more affected (p > 0.05; ES 0.37) and less affected (p > 0.05; ES 0) midstance between faster (≥ 0.8 m/s) and slower walkers (< 0.8 m/s). In contrast, dynamic postural control and walking quality were significantly worse in those participants who walked slower (p < 0.01; ES > 0.80). Prevalence of abnormality was low, capturing 19 % and 26 % of participants for the more affected and less affected lower limb PAD scores.

Significance

Preliminary evidence suggests postural alignment may be impaired during walking in people with ABI. The PAD did not discriminate between slower or faster walkers within the ABI cohort. Further research is required to determine the optimal method for measuring postural alignment during walking.

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

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.