脑卒中偏瘫患者步态参数与平衡功能的关系

doi:10.3969/j.issn.1006-9771.2022.01.006

Abstract

Abstract:

Objective To investigate the relationship between gait spatiotemporal parameters and balance function in stroke hemiplegic patients. Methods From September, 2018 to March, 2020, 76 stroke hemiplegic patients (38 in Brunnstrom Ⅳ and V, respectively) were assessed balance function with Active Balancer EAB-100 and Star Excursion Balance Test (SEBT), and gait parameters of speed, cadence and asymmetry, named step length asymmetry ratio (SLA), swing time asymmetry ratio (SWTA), stance time asymmetry ratio (STA), maximum flexion angle ratio (MFA) of hip and knee. The correlation among gait parameters and balance function was analysed. Results The balance and gait parameters were better in those in Brunnstrom V than in Brunnstrom Ⅳ (|t| > 2.268, P < 0.05). The speed and cadence correlated with the most balance indexes (|r| > 0.335, P < 0.05). SLA correlated with SEBT in Brunnstrom Ⅳ patients (r = -0.467~-0.613, P < 0.01), while it correlated with medial-lateral (M-L) stability limits in Brunnstrom V patients (r = -0.356, P = 0.028). SWTA correlated with stability limit of Anterior-Posterior (A-P) (r = -0.335, P = 0.040) and M-L (r = 0.510, P = 0.001), and most of SEBT (r = -0.330~ -0.445, P < 0.05) in Brunnstrom Ⅳ patients. MFA of hip and knee correlated with balance indexes in Brunnstrom Ⅳ patients (|r| > 0.326, P < 0.05), while MFA of knee correlated with most balance indexes in Brunnstrom V patients (r > 0.329, P < 0.05), and MFA of hip correlated with A-P stability limit (r = 0.369, P = 0.023). Conclusion Both speed and cadence of steps can well respond to the balance function in stroke hemiplegic patients. For the asymmetry, it is related with balance in patients with poorer recovery.

Key words: stroke, gait, balance, symmetry

CLC Number:

R743.3

WANG Ya'nan,ZHANG Tong,DU Xuejing,ZHU Xiaomin,LIU Yuanmin. Correlation between gait parameters and balance in stroke hemiplegic patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(1): 38-43.

Figures/Tables 3

项目			Ⅳ期组(n = 38)							Ⅴ期组(n = 38)
项目			步速	步频	步长RI	支撑期RI	摆动期RI	髋关节屈曲RI	膝关节屈曲RI	步速	步频	步长RI	支撑期RI	摆动期RI	髋关节屈曲RI	膝关节屈曲RI
平衡检测仪	前后	r	0.631	0.504	-0.273	0.028	-0.335	0.575	0.666	0.608	0.357	-0.285	-0.095	0.064	0.369	0.523
		P	< 0.001	0.001	0.098	0.867	0.040	< 0.001	< 0.001	< 0.001	0.028	0.083	0.569	0.701	0.023	0.001
	内外	r	0.673	0.484	-0.313	-0.010	-0.297	0.545	0.674	0.657	0.317	-0.356	-0.245	0.288	0.222	0.124
		P	< 0.001	0.002	0.056	0.951	0.071	< 0.001	< 0.001	< 0.001	0.053	0.028	0.139	0.079	0.181	0.457
	内外	r	-0.692	-0.602	0.292	-0.130	0.510	-0.723	-0.540	-0.335	-0.229	0.104	-0.095	0.097	-0.206	-0.063
	比	P	< 0.001	< 0.001	0.075	0.438	0.001	< 0.001	< 0.001	0.040	0.166	0.533	0.570	0.563	0.215	0.705
SEBT 患侧支撑	前	r	0.775	0.656	-0.503	0.296	-0.445	0.726	0.506	0.825	0.638	-0.147	-0.112	0.161	0.145	0.422
		P	< 0.001	< 0.001	0.001	0.071	0.005	< 0.001	0.001	< 0.001	< 0.001	0.379	0.503	0.334	0.385	0.008
	后内	r	0.726	0.588	-0.467	0.251	-0.375	0.526	0.631	0.682	0.389	-0.239	-0.036	0.090	0.031	0.247
		P	< 0.001	< 0.001	0.003	0.128	0.020	0.001	< 0.001	< 0.001	0.016	0.148	0.829	0.589	0.582	0.135
	后外	r	0.740	0.644	-0.542	0.235	-0.361	0.606	0.509	0.658	0.408	-0.260	0.061	-0.103	0.126	0.329
		P	< 0.001	< 0.001	< 0.001	0.155	0.026	< 0.001	0.001	< 0.001	0.011	0.115	0.716	0.537	0.449	0.044
SEBT 健侧支撑	前	r	0.740	0.596	-0.579	0.364	-0.330	0.578	0.326	0.630	0.578	-0.039	-0.122	0.181	0.046	0.348
		P	< 0.001	< 0.001	< 0.001	0.025	0.043	< 0.001	0.045	< 0.001	< 0.001	0.817	0.466	0.278	0.783	0.032
	后内	r	0.727	0.539	-0.503	0.211	-0.260	0.537	0.525	0.674	0.432	-0.284	-0.144	0.189	0.023	0.345
		P	< 0.001	< 0.001	0.001	0.204	0.114	0.001	0.001	< 0.001	0.007	0.084	0.389	0.255	0.889	0.034
	后外	r	0.756	0.670	-0.613	0.109	-0.294	0.683	0.531	0.832	0.401	-0.330	-0.106	0.080	0.121	0.333
		P	< 0.001	< 0.001	< 0.001	0.515	0.073	< 0.001	0.001	< 0.001	0.013	0.043	0.526	0.635	0.469	0.041

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项目	Ⅳ期组 (n = 38)	Ⅴ期组 (n = 38)	t/χ²值	P值
性别(男/女)/n	22/16	20/18	0.213	0.645
年龄/岁	39.45±7.50	40.66±10.07	-0.594	0.554
体质量/kg	67.97±8.80	70.18±5.59	-2.189	0.195
身高/m	1.71±0.08	1.73±0.06	-1.507	0.136
BMI/kg·m^-2	23.10±1.22	23.31±1.36	-0.735	0.464
性质(出血/梗死)/n	10/28	16/22	2.105	0.147
偏瘫侧(左/右)/n	16/22	19/19	0.477	0.490

项目		Ⅳ期组(n = 38)	Ⅴ期组(n = 38)	t值	P值
平衡检测仪	前后/mm	89.4±23.7	113.9±19.6	4.908	< 0.001
	内外/mm	118.3±26.2	152.6±19.1	4.834	< 0.001
	内外比/%	1.4±0.3	1.1±0.1	-4.088	< 0.001
SEBT患侧支撑	前/%	41.4±10.7	53.9±7.7	5.937	< 0.001
	后内/%	56.9±11.8	69.9±8.1	5.585	< 0.001
	后外/%	46.4±12.6	59.1±10.0	4.876	< 0.001
SEBT健侧支撑	前/%	52.5±8.3	63.3±6.8	6.206	< 0.001
	后内/%	70.5±11.2	79.5±8.6	3.937	< 0.001
	后外/%	57.1±10.6	68.8±12.7	4.345	< 0.001
步态分析	步速/cm·s^-1	45.7±17.5	73.5±19.1	6.630	< 0.001
	步频/min^-1	74.5±19.4	96.8±14.6	5.655	< 0.001
	步长RI	1.22±0.11	1.07±0.06	-7.422	< 0.001
	支撑期RI	0.94±0.11	0.98±0.07	2.322	0.023
	摆动期RI	1.16±0.34	1.02±0.10	-2.268	0.026
	髋屈曲RI	0.68±0.15	0.87±0.14	6.025	< 0.001
	膝屈曲RI	0.61±0.21	0.79±0.15	4.318	< 0.001

Correlation between gait parameters and balance in stroke hemiplegic patients

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