脑卒中患者跨越不同高度障碍物的运动学分析

Kinematic analysis of crossing obstacle with different height following stroke

目的:探索脑卒中患者跨越不同高度障碍物的运动学机制。方法:将12名脑卒中患者和12名年龄相配的健康老年人分为脑卒中组和正常组,采用英国Vicon三维运动分析系统及两个力台获得两组受试者平地行走的时空参数及跨越10%,20%,30%腿长高度障碍物的关节角度、肢端-障碍物距离等运动学参数。结果:在跨越不同高度的障碍物时,与正常组相比,脑卒中患者骨盆左右倾斜角度增大,跟随腿膝关节屈曲角度增大,先行腿和跟随腿髋关节外展角度增加,而先行腿足跟-障碍物距离减小。结论:跨越障碍物时,脑卒中患者采用了非正常的跨越障碍物模式,增加了能量的消耗,同时摔倒风险也增加了;可以通过三维运动分析系统发现脑卒中患者异常的跨越障碍物模式,从而纠正这种异常模式,增加躯体稳定性,减少能量消耗,提高动作完成效率。

Objective：To study the underlying kinematic mechanism of crossing obstacle with different heights following stroke.Method：Twelve stroke subjects and 12 aged-matched healthy control subjects were recruited and divided intostroke group and normal group. Whole-body three-dimension motion analysis system and two force plates were used to measure the spatiotemporal parameters of the walking trials as well as the angles and end-point variables when crossing obstacles of heights of 10%, 20%, and 30% leg length.Result：Compared to the normal group, the pelvic obliquity of stroke group increased, the knee flexion angle of trailing limb and the hip abduction angle of leading and trailing limb increased, while the leading heel-obstacle distance decreased.Conclusion：If stroke patients used abnormal crossing obstacle strategies, energy cost and fall risks increased.Three- dimension motion analysis system could be used to find the abnormal obstacle crossing pattern and to correct the pattern to enhance the body stability, reduce the energy cost and elevate the action efficiency.