脑卒中患者躯干核心肌群等速定量测定与步态参数的相关性研究
Trunk flexor and extensor strength and the kinematic parameters of gait among stroke survivors

目的 探讨脑卒中患者躯干核心肌群等速定量测定与步态参数的相关性。 方法 选取30例脑卒中患者作为观察组，30例健康志愿者作为对照组，应用等速测试仪获得2组受试者的躯干核心肌群肌力参数，屈肌峰力矩（FPT）、伸肌峰力矩（EPT）、躯干屈／伸肌群峰力矩（F／E)比值，采用三维步态分析系统获得2组步态参数（包括步长、步幅、步速、步频、步宽、支撑相所占比、摆动相所占比、双支撑相所占比、单支撑相所占比及步态周期）,所得数据使用SPSS 19.0版统计软件进行分析处理，揭示其相关性。 结果 选择30°/s、60°/s和90°/s三种不同的角速度测定观察组和对照组的肌力参数FPT、EPT、F/E比值，3种不同速度下测定指标组内比较,差异均统计学意义（P>0.05）；观察组的FPT、EPT、F/E比值比较均低于对照组，且组间比较差异有统计学意义（P<0.05）。观察组与对照组步态参数比较，除支撑相所占比及摆动相所占比之间差异统计学意义（P>0.05）外，其余步态参数组间比较，差异均有统计学意义（P<0.05）。观察组30°/s角速度的肌力参数指标FPT［（159.32±74.82）N·m］、EPT［（132.88±82.75）N·m］、F/E比值［（66.14±27.03）%］与步态参数指标步长［（34.12±12.09）cm］、步幅［（65.49±17.47）cm］、步速［（42.14±13.56）cm/s］、步频［（62.41±10.68）steps/min］、步宽［（20.11±4.98）cm］、支撑相所占比［（65.25±6.38）%］、摆动相所占比［（34.77±7.18）%］、双支撑相所占比［（19.18±9.47）%］、单支撑相所占比［（26.70±5.68）%］、步态周期［（1.95±0.52）S］均呈正相关（P<0.05）；其中F/E比值与步速的相关性最大（r=0.57）,其次为步频（r=0.54）。 结论 强化脑卒中偏瘫患者躯干核心肌力及优化其躯干肌群间协调能力，能够纠正其异常步态，提高其步行能力。
Objective To correlate the isokinetic strength of stroke survivors′ trunk flexors and extensors with the kinematic parameters of their gait. Methods Thirty stroke survivors and 30 healthy counterparts formed an observation group and a control group. The strength of everyone′s trunk flexors and extensors was measured isokinetically, including the flexor peak torque (FPT), extensor peak torque (EPT) and the ratio of the two (F/E). The test velocities were 30°/s, 60°/s and 90°/s. And the kinematic parameters of their gait, including the step length, stride, velocity, frequency, width and cycle time were measured using a 3D gait analysis system, as well as the percentage of stance phase, swing phase, double support phase and single support phase. Results No significant differences were found between the average FPT, EPT or F/E of the two groups at any of the three test velocities. At the 30°/s test velocity the average FPT, EPT and F/E of the observation group were all positively correlated with the average step length, stride, velocity, steps/min, width and cycle time, as well as with the stance phase, swing phase, double support phase and single support phase percentages. The strongest correlation was between F/E and velocity (r=0.57), followed by frequency (r=0.54). Conclusion litating the walking ability of stroke survivors and correcting their gait should focus on strengthening the trunk muscles and optimizing their coordination