偏瘫患者以不同步态模式通过障碍物的生物力学特征对比分析
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天津市自然科学基金项目(18JCZDJC35900,17JCZDJC36000),天津市研究生创新项目(2020YJSB104)


Comparative Analysis of Biomechanical Characteristics in Hemiplegia Patients Passing through Obstacles
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    摘要:

    目的 探讨偏瘫患者使用“健上患下”和“患上健下” 步态模式通过障碍物的生物力学特征,为降低患者跌倒 发生率提供理论依据。 方法 采用 Qualisys 动作捕捉系统和三维测力台采集 15 名偏瘫患者正常行走、健上患下、患上健下通过障碍物的运动学和动力学数据,并对数据进行处理与分析。 结果 与正常行走相比,健上患下和患上健下通过障碍物都不同程度增加了双侧的下肢活动幅度;与正常行走和健上患下相比,患上健下模式下患侧腿垂直地面反作用力出现较大波动,步态稳定性较差,具有较大跌倒风险。 结论 患者通过障碍物时,对接触障碍物的一侧肢体关节活动幅度要求较高,患侧肢适应能力较差。 在触地后单腿支撑期,垂直方向地面反作用力变化较大。 当身体重量完全转移到该侧时,容易导致患者跌倒。 相比患上健下,患者使用健上患下方式通过障碍物时能 容易保持步态稳定性,降低跌倒风险。

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    Objective To explore biomechanical characteristics of hemiplegic patients using UOHL (up obstacles with healthy leg, down obstacles with affected leg) and UOAL ( up obstacles with affected leg, down obstacles with healthy leg) to pass through obstacles, and to provide theoretical basis for reducing the incidence of falls in patients. Methods The Qualisys motion capture system and three-dimensional ( 3D) force plate were used to collect the kinematics and dynamics data of 15 hemiplegic patients passing through obstacles with normal walking mode (NWM), UOHL and UOAL, and the data were processed and analyzed. Results Compared with NWM,805 both UOHL and UOAL increased bilateral lower extremity range of motion ( ROM) to some extent. Compared with NWM and UOHL, vertical ground reaction force (GRF) of affected leg side under UOAL fluctuated more, and gait stability was worse, indicating a greater risk of falling. Conclusions When patients pass through the obstacle, the requirements for joint ROM on the side of the obstacle are relatively high, the adaptability of the affected leg side is poor. The GRF in vertical direction changes greatly during single-leg support period after touching the ground. When the body weight is completely transferred to this side, it is easy for the patient to fall. Compared with UOAL, patients can easily maintain gait stability when using UOHL to pass through obstacles, and the risk of falling will be reduced.

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周鲁星,孟庆华,刘文红,黄旭,刘姣,李猛,薛艳艳.偏瘫患者以不同步态模式通过障碍物的生物力学特征对比分析[J].医用生物力学,2022,37(5):805-811

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  • 收稿日期:2021-12-20
  • 最后修改日期:2022-01-29
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  • 在线发布日期: 2022-10-25
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