急性视力下降对偏瘫患者步态的即时影响
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1.天津体育学院;2.遵义医科大学

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The Immediate Impact of Acute Visual Acuity Decline on the Gait of Hemiplegic Patients
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1.TianJin University of Sport;2.ZunYi Medical university

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    摘要:

    目的 探究偏瘫患者视觉干预前后运动学及动力学特征变化对步态的即时影响。方法 招募30名视力正常偏瘫患者,选取不同屈光程度的平面镜(0°)、凹透镜(+150°、+450°)分别模拟正常视力、中度近视、高度近视情境进行直线行走测试,运用Qualisys三维动作捕捉系统、Kistler三维测力台对患者运动学和动力学参数进行采集,比较视觉干预前后相关指标差异性。结果 视力干预下偏瘫患者的步长、步速、关节角度均会受到影响,尤其急性视力变化后患者患侧步长、踝关节角度存在显著差异;高度近视下步长及步长对称性较中度近视下表现更好,但牺牲了步速;视力干预下步长对称性、关节角度对称性有不对称趋势;COP及COP对称性方面正常视力与高度近视间呈现极为显著差异。结论 急性视力变化会显著影响偏瘫患者步态,尤其在高度近视时步速降低和踝关节角度变化明显,中度近视时步速增加,同时各视力变化条件下COP对称性均降低,预示了更高的跌倒风险。提示在偏瘫患者康复过程中,通过施行合理的视力评估和相应的干预措施有望提高患者的行走能力和生活质量。

    Abstract:

    Objective To investigate the immediate impact of changes in kinematic and dynamic characteristics before and after visual intervention on the gait of hemiplegic patients. Methods Thirty visually normal hemiplegic patients were recruited. Recruit 30 hemiplegic patients with normal vision, select plane mirrors with different refractive degrees (0°), concave lenses (+150°, +450°) to simulate normal vision, moderate myopia, and high myopia scenarios for straight line walking tests. The Qualisys 3D motion capture system and Kistler 3D force platform were employed to collect kinematic and dynamic parameters of the patients, and the differences in related indicators before and after visual intervention were compared.Results Visual intervention affected the step length, walking speed, and joint angles of hemiplegic patients. Especially after acute changes in vision, there is a significant difference in the stride length and ankle joint angle on the patient's affected side.. Under high myopia, step length and step length symmetry were better than under moderate myopia, but at the expense of gait speed. Visual intervention led to asymmetric trends in step length symmetry and joint angle symmetry. There were very significant differences in COP and COP symmetry between normal vision and high myopia.Conclusion Acute changes in vision can significantly affect the gait of hemiplegic patients, especially when there is a notable decrease in walking speed and changes in ankle joint angles with high myopia, and an increase in walking speed with moderate myopia. Additionally, under all conditions of vision change, the symmetry of COP is reduced, indicating a higher risk of falls. This suggests that during the rehabilitation process of hemiplegic patients, reasonable vision assessment and corresponding intervention measures are expected to improve the patient's walking ability and quality of life.

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  • 收稿日期:2024-09-09
  • 最后修改日期:2024-10-20
  • 录用日期:2024-10-21
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