股四头肌痉挛对脑卒中患者跨越障碍的影响

doi:10.3969/j.issn.1006-9771.2021.07.003

Abstract

Abstract:

Objective To observe the effect of quadriceps femoris spasticity on the movement parameters in stroke patients during obstacle crossing.

Methods From October, 2017 to November, 2018, 20 stroke patients were divided into spasticity group (n = 11) and non-spasticity group (n = 9) based on the score of modified Ashworth Scale (MAS) of quadriceps femoris. A 10-camera 3D motion analysis system and two force plates were used to synchronously measure the movement parameters of the patients during obstacle crossing of 15 cm high, such as step length, step width, anterior-posterior velocity of the center of mass (COMAPV) and medio-lateral velocity of the center of mass, toe-obstacle distance of unaffected limb, toe-obstacle clearance of affected limb, heel-obstacle distance, double support phase, and the swing phases of affected and unaffected limb.

Results Compared with the non-spasticity group, the COMAPV decreased as both affected and unaffected limb above the obstacle in the spasticity group (F > 10.006, P < 0.01), as well as the toe-obstacle distance and step length before obstacle crossing (F > 13.456, P < 0.01); while, the double support phase and the step width after obstacle crossing increased (F > 4.533, P < 0.05).

Conclusion The quadriceps femoris spasticity may make the strategy of obstacle crossing more carefully for stroke patients, and less efficiently.

Key words: stroke, knee, spasticity, obstacle crossing, biomechanics

CLC Number:

R743.3

YU Xiao-ming,HUANG Shang-jun,QIAO Jun,LU Yan,HU Jun. Influences of Quadriceps Femoris Spasticity on Obstacle Crossing for Stroke Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(7): 755-759.

Figures/Tables 2

References 42

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特征	无痉挛组(n = 9)	痉挛组(n = 11)	χ²/F值	P值
性别(男/女, n)	6/3	9/2	0.617	0.396
年龄(岁)	61.33±7.53	60.02±8.79	0.129	0.724
身高(cm)	168.78±3.89	171.09±6.89	0.799	0.383
体质量(kg)	67.39±3.18	73.81±8.76	4.316	0.052
卒中类型(梗死/出血, n)	5/4	9/2	0.336	0.217
病程(d)	280.67±187.82	320.01±195.29	0.208	0.654
MAS	0.00±0.00	1.45±0.47	84.637	< 0.001
MMSE	28.11±2.52	27.55±2.02	0.311	0.584
Fugl-Meyer评定量表下肢部分	28.44±2.55	25.82±6.78	1.201	0.288
Berg平衡量表	48.89±3.79	45.73±3.72	3.519	0.077

参数	无痉挛组(n= 9)	痉挛组(n= 11)	F值	P值
COMAPV1 (m/s)	0.47±0.17	0.25±0.09	12.542	0.002
COMMLV1 (m/s)	0.02±0.01	0.02±0.02	0.082	0.778
COMAPV2 (m/s)	0.53±0.15	0.35±0.11	10.006	0.005
COMMLV2 (m/s)	0.04±0.03	0.04±0.04	0.098	0.758
TOD (m)	0.22±0.07	0.12±0.04	13.456	0.002
TOC (m)	0.13±0.04	0.11±0.08	0.211	0.651
HOD (m)	0.10±0.06	0.07±0.05	1.905	0.184
障碍前步长(m)	0.48±0.03	0.17±0.06	216.380	< 0.001
障碍后步长(m)	0.34±0.19	0.21±0.17	2.787	0.112
障碍前步宽(m)	0.08±0.06	0.10±0.04	0.608	0.446
障碍后步宽(m)	0.11±0.04	0.15±0.04	4.533	0.047
障碍前双支撑期(%)	9.23±2.33	13.34±14.62	5.381	0.032
患侧摆动期(%)	46.79±4.37	44.67±4.86	1.031	0.323
障碍中双支撑期(%)	8.18±2.50	10.60±4.35	2.180	0.157
健侧摆动期(%)	35.80±7.65	31.40±7.46	1.681	0.211

Influences of Quadriceps Femoris Spasticity on Obstacle Crossing for Stroke Patients

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