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首页> 外文期刊>Journal of Biomechanics >Muscle contributions to support during gait in an individual with post-stroke hemiparesis.
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Muscle contributions to support during gait in an individual with post-stroke hemiparesis.

机译：中风后偏瘫患者步态中的肌肉支持。

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摘要

Walking requires coordination of muscles to support the body during single stance. Impaired ability to coordinate muscles following stroke frequently compromises walking performance and results in extremely low walking speeds. Slow gait in post-stroke hemiparesis is further complicated by asymmetries in lower limb muscle excitations. The objectives of the current study were: (1) to compare the muscle coordination patterns of an individual with flexed stance limb posture secondary to post-stroke hemiparesis with that of healthy adults walking very slowly, and (2) to identify how paretic and non-paretic muscles provide support of the body center of mass in this individual. Simulations were generated based on the kinematics and kinetics of a stroke survivor walking at his self-selected speed (0.3 m/s) and of three speed-matched, healthy older individuals. For each simulation, muscle forces were perturbed to determine the muscles contributing most to body weight support (i.e., height of the center of mass during midstance). Differences in muscle excitations and midstance body configuration caused paretic and non-paretic ankle plantarflexors to contribute less to midstance support than in healthy slow gait. Excitation of paretic ankle dorsiflexors and knee flexors during stance opposed support and necessitated compensation by knee and hip extensors. During gait for an individual with post-stroke hemiparesis, adequate body weight support is provided via reorganized muscle coordination patterns of the paretic and non-paretic lower limbs relative to healthy slow gait.
机译：步行需要肌肉协调才能在单步站立时支撑身体。中风后协调肌肉的能力受损，经常会损害步行性能，并导致极低的步行速度。中风后偏瘫的步态缓慢，由于下肢肌肉兴奋不对称而进一步复杂化。当前研究的目的是：（1）比较卒中后偏瘫后继发肢体姿势弯曲和肢体姿势缓慢的人的肌肉协调方式，以及健康步伐缓慢的成年人的肌肉协调方式，以及（2）识别出姿势性和非姿势性-腹部肌肉为该个体的身体质心提供支撑。根据中风幸存者以其自行选择的速度（0.3 m / s）行走的运动学和动力学以及三个速度匹配的健康老年人的运动学和动力学进行了仿真。对于每个模拟，都会对肌肉力量进行摄动，以确定对体重支撑起最大作用的肌肉（即中位期间质心的高度）。与健康慢步态相比，肌肉刺激和中位身体形态的差异导致平步和非平步踝plant屈对中位支撑的贡献较小。在站立期间，对局促性踝背屈肌和膝屈肌的激励与支撑相反，需要通过膝关节和髋关节伸肌进行补偿。在中风后偏瘫患者的步态中，相对于健康的慢步态，通过paretic和非paretic下肢的重组肌肉协调模式，可以提供足够的体重支持。

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