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Does stroke-induced sensorimotor impairment and perturbation intensity affect gait-slip outcomes?
Journal of Biomechanics ( IF 2.4 ) Pub Date : 2021-01-17 , DOI: 10.1016/j.jbiomech.2021.110255
Shamali Dusane 1 , Rachana Gangwani 2 , Prakruti Patel 3 , Tanvi Bhatt 4
Affiliation  

People with chronic stroke (PwCS) demonstrate similar gait-slip fall-risk on both paretic and non-paretic side. Compensatory stepping and slipping limb control are crucial to reduce gait-slip fall-risk. Given the unpredictable intensities of real-life perturbations, this study aimed to determine whether recovery from paretic or non-paretic slips vary as a function of perturbation intensity among PwCS. Forty-four PwCS were assigned to non-paretic low intensity slip, non-paretic high intensity slip, paretic low intensity slip, or paretic high intensity slip group. Participants were subjected to a novel overground gait-slip with a distance of 24 cm (low) or 45 cm (high), under either limb. Recovery strategies, center of mass (CoM) state stability and slipping kinematics were analyzed. Both non-paretic high and low intensity groups demonstrated similar percentage of aborted and recovery stepping, however, paretic high intensity group demonstrated greater aborted stepping (p > 0.05). Both high and low intensity paretic slip groups demonstrated reduced post-slip CoM stability relative to the non-paretic slip groups (p < 0.05). Slip displacement was greater in paretic high group compared with non-paretic high group (p < 0.05). Greater slip displacement at higher intensity was noted only in paretic slip group (p < 0.05). The slip velocity was faster in paretic groups compared to non-paretic slip groups (p < 0.05). Paretic slips showed lower stability at both intensities associated with difficulty in modulating slipping kinematics and resorting to an increased aborted stepping strategy compared to non-paretic slip. These findings are suggestive of developing balance interventions for improving both compensatory non-paretic limb stepping and reactive control of slipping paretic limb for fall-risk reduction.



中文翻译:

中风诱发的感觉运动障碍和摄动强度会影响步态滑移结果吗?

患有慢性卒中(PwCS)的人无论在坐骑还是非坐骑方面都表现出类似的步态滑倒风险。补偿性踩踏和滑倒肢体控制对于降低步态滑倒的跌落风险至关重要。考虑到现实生活中不可预测的扰动强度,本研究旨在确定在PwCS中,从表层滑移或非表层滑移的恢复是否随扰动强度而变化。将44个PwCS分配到非参数低强度滑移,非参数高强度滑移,参数低强度滑移或参数高强度滑移组。参与者在任一肢下进行了新型的地面步态滑行,滑行距离为24厘米(低)或45厘米(高)。分析了恢复策略,质心(CoM)状态稳定性和滑移运动学。非paretic高强度组和低强度组均显示出相似的流产和恢复脚步百分比,但是,paretic高强度组表现出较高的流产脚步(p> 0.05)。高强度和低强度腹股沟滑膜组均显示出滑移后CoM稳定性相对于非腹股沟滑膜组降低(p <0.05)。高偏瘫组的滑移较非偏瘫高组明显(p <0.05)。仅在paretic滑倒组中,在较高强度下出现更大的滑倒位移(p <0.05)。与非paretic滑移组相比,paretic组的滑移速度更快(p <0.05)。与非paretic滑移相比,paretic滑移在两种强度下都显示出较低的稳定性,这与调节滑移运动学和诉诸增加的中止踩踏策略有关。

更新日期:2021-02-11
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