老年脑卒中偏瘫患者不同站立姿势下静态平衡特征的比较

doi:10.3969/j.issn.1006-9771.2026.09.007

Abstract

Abstract:

Objective To compare static balance characteristics under different standing postures in older patients with post-stroke hemiplegia.

Methods A total of 38 older patients with post-stroke hemiplegia in Jiangsu Shengze Hospital from September, 2022 to August, 2024 were enrolled. Static balance was assessed using the ProKin Balance Testing and Training System under seven standing postures: bipedal stance (BS), affected semi-tandem stance (ASTS), unaffected semi-tandem stance (USTS), affected tandem stance (ATS), unaffected tandem stance (UTS), unaffected monopedal stance (UMS) and self-selected stance (SS). Participants were required to maintain each posture for 15 seconds. Center-of-pressure (COP) parameters were recorded, including mean sway velocity in the anteroposterior direction (VAP), mean sway velocity in the mediolateral direction (VML), sway area (SA), sway path length (SL), standard deviation in the anteroposterior direction (SDAP), and standard deviation in the mediolateral direction (SDML).

Results Main effect of standing posture was significant in all COP parameters (F > 39.793, χ² = 109.632, P< 0.001). SS showed smaller postural sway for most COP measures than the other postures (P < 0.05). VAP, VML, SA and SL were higher during UMS than during the other postures (P < 0.05). COP parameters during UTS were higher than those during BS, ASTS and USTS (P < 0.05), and VAP, SA, SL and SDAP during UTS were higher than those during ATS (P < 0.05). Except for VML and SDML, COP parameters during ATS were higher than those during BS, ASTS and USTS (P < 0.05). VAP during USTS was higher than that during BS (P < 0.05).

Conclusion In older patients with post-stroke hemiplegia who have relatively good independent standing ability, COP parameters differ across standing postures. Postural sway is relatively small during SS, and great during UMS and UTS. The anteroposterior positioning of the feet during tandem stance may influence static balance control.

Key words: older adults, stroke, hemiplegia, standing posture, static balance

CLC Number:

R743.3

Su Panpan, He Chuan, Qiongji , Meng Dianhuai. Comparison of static balance characteristics under different standing postures in older patients with post-stroke hemiplegia[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(9): 1052-1060.

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References 37

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特征	数值
性别(男/女)/n	32/6
年龄/岁	65.85±5.41
身高/m	1.68±0.09
体质量/kg	69.93±11.08
体质量指数/(kg·m^-2)	24.83±3.16
脑卒中类型(缺血/出血)/n	31/7
脑卒中病程/月	4.96±2.32
下肢Brunnstrom分期/n
III期	19
IV期	11
V期	8
计时起立-行走测试/s	26.25±15.03
30 s坐站测试/个	8.71±2.46
偏瘫侧(左/右)/n	21/17
过去12个月内有跌倒史/n	6

任务编号	任务名称	操作定义
任务1	BS	双足内侧缘并拢相触，双足跟并拢，双足呈平行位，脚尖向前
任务2	ASTS	患侧足在前，患足跟接触健足足弓中部
任务3	USTS	健侧足在前，健足跟接触患足足弓中部
任务4	ATS	患侧足在前，患足的足跟紧贴健足的脚尖，双足呈直线前后排列
任务5	UTS	健侧足在前，健足的足跟紧贴患足的脚尖，双足呈直线前后排列
任务6	UMS	健侧下肢单腿支撑，患侧腿抬离地面，尽量保持躯干直立，骨盆维持中立位
任务7	SS	患者选择自我感觉最稳定、最舒适的站立姿势

站姿	n	VAP	VML
BS	38	12.46±3.93	10.12±3.35
ASTS	38	14.48±4.46	12.27±3.44
USTS	38	17.46±6.49	12.44±3.83
ATS	38	20.99±7.29	17.82±4.65
UTS	38	28.11±10.04	16.91±3.96
UMS	38	38.62±13.01	30.02±7.17
SS	38	10.35±3.33	6.51±2.36
F值		80.848	139.772
P值		< 0.001	< 0.001

任务	ASTS	USTS	ATS	UTS	UMS	SS
BS	2.026	5.009^a	8.535^b	15.649^b	26.167^b	-2.105^a
ASTS		2.982	6.609^b	13.623^b	24.140^b	-4.132^a
USTS			3.526	10.640^b	21.158^b	-7.114^b
ATS				7.114^a	17.632^b	-10.640^b
UTS					10.518^a	-17.754^b
UMS						-28.272^b

任务	BS	ASTS	USTS	ATS	UTS	UMS
ASTS	2.149
USTS	2.232	0.175
ATS	7.702^a	5.553^a	5.377^a
UTS	6.781^a	4.632^a	4.456^a	-0.921
UMS	19.895^a	17.749^a	17.570^a	12.193^a	13.114^a
SS	-3.614^a	-5.763^a	-5.939^a	-11.316^a	-10.395^a	-23.509^a

Comparison of static balance characteristics under different standing postures in older patients with post-stroke hemiplegia

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站姿	n	SA/mm²	SL/mm
BS	38	471.12±219.11	317.11±95.83
ASTS	38	548.47±222.99	353.20±91.79
USTS	38	658.14±301.08	390.34±116.76
ATS	38	842.61±403.75	518.88±131.17
UTS	38	1074.15±522.28	631.62±207.19
UMS	38	2283.53±1405.85	914.55±253.19
SS	38	270.87±140.66	236.97±76.21
F值		53.796	112.232
P值		< 0.001	< 0.001

站姿	ASTS	USTS	ATS	UTS	UMS	SS
BS	77.342	187.018	371.272^a	603.026^a	1812.412^a	-200.254^a
ASTS		109.675	294.149^a	525.684^a	1735.070^a	-277.596^a
USTS			184.474^b	416.008^a	1625.395^a	-387.272^a
ATS				231.535^b	1440.921^a	-571.746^a
UTS					1209.386^a	-803.281^a
UMS						-2012.667^a

站姿	BS	ASTS	USTS	ATS	UTS	UMS
ASTS	36.088
USTS	73.228	37.140
ATS	201.772^a	165.684^a	128.544^a
UTS	314.509^a	278.421^a	241.281^a	112.737^a
UMS	597.439^a	561.351^a	524.211^a	395.667^a	282.930^a
SS	-80.140^a	-116.228^a	-153.368^a	-281.912^a	-394.649^a	-677.579^a

站姿	n	SDAP/mm	SDML/mm
BS	38	5.36±1.63	4.67(3.67,6.00)
ASTS	38	5.67±2.02	4.67(3.67,5.75)
USTS	38	6.23±2.42	4.83(4.00,6.33)
ATS	38	7.55±3.57	5.00(4.33,6.41)
UTS	38	10.11±3.41	5.67(4.58,6.83)
UMS	38	11.59±3.94	9.67(6.92,17.75)
SS	38	4.81±1.46	2.83(2.00,3.67)
F/χ²值		39.793	109.632
P值		< 0.001	< 0.001

站姿	ASTS	USTS	ATS	UTS	UMS	SS
BS	0.316	0.868	2.193^a	4.746^b	6.237^b	-0.553
ASTS		0.553	1.877^a	4.430^b	5.921^b	-0.868
USTS			1.325	3.877^b	5.368^b	-1.421
ATS				2.553^b	4.044^b	-2.746^a
UTS					1.491	-5.298^b
UMS						-6.789^b

站姿	BS	ASTS	USTS	ATS	UTS	UMS
ASTS	0.133
USTS	-1.142	-1.274
ATS	-1.699	-1.832	-0.558
UTS	-3.159^a	-3.292^a	-2.018	-1.460
UMS	-6.160^b	-6.292^b	-5.018^b	-4.460^b	-3.000
SS	3.478^a	3.345^a	4.620^b	5.177^b	6.637^b	9.638^b

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