抑制力对中风后跑步机行走时推进力和其他步态特征的影响

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-09-08 DOI:10.1016/j.clinbiomech.2025.106664

S. Minkes-Weiland , H. Houdijk , S. Floor , P.P. Hartman , H.A. Reinders-Messelink , L.H.V. van der Woude , A.R. den Otter

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引用次数: 0

摘要

背景：中风后推进能力下降与行走能力下降有关。当骨盆受到约束时，需要更多的推进力来向前推进。这可能会刺激中风后患者的推进能力。在将约束力纳入训练之前，必须评估它们对推进力学和其他步态特征的影响。本研究主要探讨：(1)在跑步机上行走时，约束力对脑卒中后人体推进力、制动力和机械功的直接影响；(2)在跑步机上行走时，约束力对步长对称性、单次支撑时间对称性和肌肉活动的影响。此外，我们探讨了这些影响是否随步态速度和力的大小而变化。方法13例中风后患者分别以0.28 m/s和0.56 m/s的速度在跑步机上行走，同时施加水平约束力（体重的0%、5%或10%）在骨盆上。行走时，记录双侧臀中肌、股直肌、股内侧肌、股二头肌、胫骨前肌、腓肠肌内侧肌和比目鱼肌的地面反作用力和肌肉活动。研究发现，施加高达体重10%的约束力增加了推进冲动和机械功，同时减少了制动冲动。尽管在步长对称或摇摆相对称上没有发现明显的影响，但在有抑制力的情况下行走时，观察到肌肉活动的微妙变化。解释：高达体重10%的抑制力可以激活推进能力。未来的研究应该探索这种直接影响如何转化为长期的训练效果。

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Effects of restraining forces on propulsion and other gait characteristics during treadmill walking post-stroke

Background

A decreased propulsive capacity post stroke is associated with a diminished walking ability. When walking with a restraining force applied to the pelvis, more propulsion is required to enable forward progression. This may stimulate propulsion capacity in people post-stroke. Before incorporating restraining forces into training, their effects on propulsion mechanics and other gait characteristics must be evaluated. This study investigated: (1) the immediate bilateral effects of restraining forces during treadmill walking on propulsive force, braking force, and mechanical work in people post-stroke, and (2) the impact of this manipulation on step length symmetry, single support time symmetry and muscle activity. Additionally, we explored whether these effects vary with gait speed and force magnitude.

Methods

13 individuals post-stroke walked on a treadmill at 0.28 m/s and 0.56 m/s while a horizontal restraining force (0 %, 5 % or 10 % of their body weight) was applied to the pelvis. During walking, ground reaction forces and muscle activity of gluteus Medius, rectus Femoris, vastus Medialis, biceps Femoris, tibialis anterior, medial gastrocnemius and soleus were bilaterally recorded

Findings

Applying restraining forces up to 10 % of body weight increased propulsive impulse and mechanical work while reducing braking impulse. Although no significant effects were found on step length symmetry or swing phase symmetry, subtle changes in muscle activity were observed when walking with restraining forces

Interpretation

Restraining forces up to 10 % of body weight can activate propulsive capacity. Future research should explore how this direct effect translates into long-term training effects.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.