Balasubramanian,et al: Relationship Between Step Length Asymmetry and Walking Performance in Subjects With Chronic Hemiparesis.Arch Phys Med Rehabil. 2007 Jan;88(1):43-9.
the primary purpose of our study was to explore the correlation between step length asymmetry and propulsive forces in an attempt to quantify the relationship between step length asymmetry and poststroke hemiparetic walking performance.
We recruited 49 subjects with chronic hemiparesis (42 men,7 women; age standard deviation, 62.7±10.2y; time since stroke, 4.25±3.67y; affected side: left, 25; right, 24).
Inclusion criteria were: at least 6 months poststroke, unilateral weakness, and the ability to walk 10m in 50 seconds or less without manual assistance.
Subjects were allowed to use their assistive devices (ankle-foot orthosis [AFO] and/or cane) during the testing. Subjects were excluded from the study if they had any orthopedic or neurologic conditions in addition to the stroke, had more than 1 cerebrovascular accident, or were unable to provide informed consent.
Brunnstrom motor recovery stages were used to determine the severity of hemiparesis for the subjects. Based on their Brunnstrom stage, 3 groups of subjects with differing hemiparetic severity were identified. Subjects (n=19) in the severe hemiparesis group (Brunnstrom stage 3) ,Subjects (n=20) in the moderate hemiparesis group (Brunnstrom stages 4,5) , Subjects (n=10) in the mild hemiparesis group (Brunnstrom stage 6) .←短くしています
測定項目は、歩行速度(快適・最大)、推進力、ステップ長、スイング時間、プレスイング時間とした。
ステップ長の非対称性(SLR)はP/NPで算出した。
また下線のパラメータは全て快適歩行時のみ算出した。
統計解析はSLRと推進力、歩行速度の関係性をピアソンの積率相関係数を用いて解析した。
またSLRと運動麻痺の重症度はスピアマンの順位相関係数を用いて解析した。
(GAITRite)Spatiotemporal variables included in this study were self-selected and fastest walking speed, step lengths, swing times, and preswing times (time spent in double-support
phase of gait cycle). Paretic and nonparetic step length, swing time, and preswing time data were averaged only from the trials of self-selected walking speed. Subjects’ self-selected walking speed was categorized as: speed less than 0.4m/s (household ambulatory); 0.4 to 0.8m/s (limited community); or speed greater than 0.8m/s (community ambulatory).
(Forceplate)Paretic propulsion (Pp) was then calculated from the propulsive impulse.
Relationships between the step length asymmetry (expressed as SLR), ground reaction forces, and walking speed were characterized using the Pearson correlation coefficient (r) and that between SLR and hemiparetic severity using the nonparametric Spearman correlation coefficient.
