Background

Whole-body movement adjustments during gait are common post-stroke, but comprehensive ways of quantifying and evaluating gait from a whole-body perspective are lacking.

Research question

Can novel kinematic variables related to Center of Mass (CoM) position discriminate side asymmetries as well as coordination between the upper and lower body during gait within persons post-stroke and compared to non-disabled controls?

Methods

Thirty-one persons post-stroke and 41 age-matched non-disabled controls walking at their self-selected speed were recorded by 3D motion capture. The Ankle-CoM Inclination Angle (A-CoMIA) and the Head-CoM Inclination Angle (H-CoMIA) defined the angle between the CoM and the ankle and the head, respectively, in the frontal plane. These angles and their angular velocities were compared between groups, and with regard to motor impairment severity during all phases of the gait cycle (GC) using a functional interval-wise testing analysis suitable for curve data. Upper and lower body coordination was assessed using cross- correlation.

Results

The A-CoMIA was symmetrical between body sides in persons post-stroke but larger compared to controls. The angular velocity of A-CoMIA also differed when compared to controls. The H-CoMIA was consistently asymmetrical in persons post-stroke and larger than in controls throughout the stance phase. There were only minor group differences in the angular velocity of H-CoMIA, with some side asymmetry in persons post-stroke. The A-CoMIA of the non-affected side, and the H- CoMIA, discriminated between persons with more severe impairments compared to those with milder impairments post-stroke. The variables showed strong cross- correlations in both groups.

Significance

The A-CoMIA and Head-CoMIA discriminated post-stroke gait from non-disabled, as well as motor impairment severity. These variables with the advantageous curve analysis during the entire GC add valuable whole-body information to existing parameters of post-stroke gait analysis through assessment of symmetry and upper and lower body coordination.

中文翻译：

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脚踝和头部相对于质心的倾斜角度确定中风后步态的偏离。

背景

步态中的全身运动调节是中风后的常见现象，但是缺乏从全身的角度量化和评估步态的综合方法。

研究问题

是否可以将与质心（CoM）位置相关的新颖运动学变量区分中风后人在步态中的步态不对称以及上身与下身之间的协调性，并与非残疾对照进行比较？

方法

通过3D运动捕捉，记录了31人中风后和41位年龄相匹配的非残疾对照者以他们自己选择的速度行走。踝-CoM倾斜角（A-CoMIA）和头-CoM倾斜角（H-CoMIA）分别定义了额叶平面中CoM与脚踝和头部之间的角度。使用适合于曲线数据的功能性区间测试分析，比较了各组之间的这些角度及其角速度，以及在步态周期（GC）所有阶段的运动损伤严重程度。上身和下身的协调性使用互相关进行评估。

结果

A-CoMIA在卒中后患者的身体两侧之间是对称的，但与对照组相比更大。与对照相比，A-CoMIA的角速度也有所不同。H-CoMIA在卒中后患者中始终是不对称的，并且在整个站立阶段均大于对照组。H-CoMIA的角速度仅有微小的组间差异，中风后的人侧面有些不对称。与卒中后轻度障碍者相比，未受影响一侧的A-CoMIA和H-CoMIA区分了轻度障碍者。变量在两组中均显示出很强的互相关性。

意义

A-CoMIA和Head-CoMIA将中风后步态与非残疾以及运动障碍的严重程度区分开来。这些变量在整个GC期间具有有利的曲线分析功能，可通过评估对称性和上，下身协调性，为中风后步态分析的现有参数增加有价值的全身信息。