增强脑卒中患者的步态生物力学:功能性电刺激在台阶到台阶转换中的作用。

IF 1.8 Q3 REHABILITATION
Felipe Covarrubias-Escudero, Juan Pablo Appelgren-Gonzalez, Gustavo Nuñez-Saavedra, Denisse Urrea-Baeza, Gonzalo Varas-Diaz
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引用次数: 0

摘要

背景和目的:中风通常会导致肌肉无力、运动控制能力下降和步态异常,如足下垂和推进力不足,从而影响体重转移和行走效率。传统的干预措施,如踝足矫形器和肉毒杆菌毒素解决这些损伤,但往往不能激活参与推进的肌肉。功能性电刺激(FES)已经显示出增强肌肉激活和步态速度的潜力,但其对生物力学参数的影响,特别是对步到步转换的影响,仍然没有得到充分的探索。方法:采用随机交叉设计,包括18名卒中患者,他们在有和没有功能电刺激(FES)的情况下行走。记录运动数据和地面反作用力(GRF)以评估台阶到台阶的过渡。结果测量包括质心(CoM)的最小垂直速度(Vvmin)和后脚(Fback)和前脚(fffront)之间的力比(ratio)。讨论:应用于特定下肢肌肉的FES改善了关键的生物力学步态参数,包括增强力分布和更好地控制质心(CoM)。这些发现表明,FES可以优化步态力学,特别是在一步到一步的过渡过程中,并提高中风患者的行走效率。需要进一步的研究来评估其长期效果并探索其与康复方案的结合。试验注册:该研究已在Clinical Trials.gov注册(NCT06237972)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enhancing Gait Biomechanics in Persons With Stroke: The Role of Functional Electrical Stimulation on Step-To-Step Transition.

Background and purpose: Stroke often causes muscle weakness, reduced motor control, and gait abnormalities, such as foot drop and propulsion deficits, which impair weight transfer and walking efficiency. Traditional interventions such as ankle-foot orthoses and botulinum toxin address these impairments but often fail to activate the muscles involved in propulsion. Functional electrical stimulation (FES) has shown potential to enhance muscle activation and gait speed, but its effects on biomechanical parameters, particularly on step-to-step transitions, remain insufficiently explored.

Methods: A randomized crossover design included 18 individuals with stroke who walked with and without functional electrical stimulation (FES). Kinematic data and ground reaction forces (GRF) were recorded to evaluate step-to-step transitions. Outcome measures included the minimum vertical velocity (Vvmin) of the center of mass (CoM) and the force ratio (FRatio) between the back foot (Fback) and front foot (Ffront).

Results: FES significantly reduced the force ratio (FRatio) (p < 0.001), indicating improved force distribution toward the back foot. The minimum vertical velocity (Vvmin) of the center of mass (CoM) occurred earlier with FES (0.470 ± 0.032) compared with No FES (0.513 ± 0.033; p < 0.001), demonstrating enhanced control of CoM redirection during gait.

Discussion: FES applied to specific lower limb muscles improved critical biomechanical gait parameters, including enhanced force distribution and better control of the center of mass (CoM). These findings suggest that FES can optimize gait mechanics, particularly during step-to-step transitions, and improve walking efficiency in individuals with stroke. Further research is needed to assess its long-term effects and explore its integration into rehabilitation protocols.

Trial registration: The study was registered with Clinical Trials.gov (NCT06237972).

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来源期刊
CiteScore
3.30
自引率
5.90%
发文量
53
期刊介绍: Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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