双任务介入对社区脑卒中患者步态参数及其对称性的影响  

Effects of Dual-Task Intervention on Gait Parameters and Symmetry in Community Stroke Patients

作　　者：刘鑫玥 刘鹏波 霍洪峰[1,3] LIU Xinyue;LIU Pengbo;HUO Hongfeng(College of Physical Education,Hebei Normal University,Shijiazhuang 050024,China;Department of Rehabilitation,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China;Hebei Key Laboratory of Human Sports BioInformation Evaluation,Shijiazhuang 050024,China)

机构地区：[1]河北师范大学体育学院,石家庄050024 [2]河北省中医院康复科,石家庄050011 [3]河北省人体运动生物信息测评重点实验室,石家庄050024

出　　处：《医用生物力学》2023年第6期1114-1119,共6页Journal of Medical Biomechanics

基　　金：河北省科技支撑项目(16275709);河北省专业学位研究生教学案例建设项目(KCJSZ2020031)。

摘　　要：目的对比社区脑卒中患者单任务步行与不同类型和不同负荷双任务步行时步态参数及其对称性的差异。方法利用Simi Motion三维动作分析系统采集20名处于慢性恢复期的社区脑卒中患者在单任务步行及不同负荷认知双任务步行和运动双任务步行时步态参数,并间接计算出其对称指数。采用单因素重复测量方差分析对比单任务步行与不同双任务步行时步态参数及其对称性差异。结果与单任务步行相比,社区脑卒中患者在高低负荷认知任务介入时步速、患侧步长、健侧摆动相占比均降低,困难认知任务介入时健侧步宽和健侧、患侧支撑相占比增加、健侧步长和患侧摆动相占比降低,摆动相占比对称指数减小(P<0.05)。结论社区脑卒中患者主要通过降低步速、缩减步长、降低摆动相占比、增加步宽和支撑相占比,改变步态模式来应对认知任务干扰,对于步态稳定性,高负荷认知任务的介入,会增加社区脑卒中患者摆动相占比的不对称性程度,降低其步态稳定性。Objective To compare the difference of gait parameter and symmetry between single task walking and double-task walking with different types and different loads in community stroke patients.Methods The gait parameters of 20 community stroke patients in chronic convalescence during single task walking,cognitive double-task walking and motor double-task walking with different loads were collected by Simi Motion three-dimensional(3D) motion analysis system,and the symmetry index(SI) was calculated indirectly.The single-factor repeated measure variance analysis was used to compare gait parameters and symmetry differences between single task walking and walking with different double tasks.Results Compared with single task walking,the walking speed,step length of affected leg side and the swing phase proportion of healthy leg side in community stroke patients during intervention of high-low load cognitive tasks were decreased(P<0.05),while step width of healthy side and the support phase proportion of healthy side and affected side was increased during intervention of difficult cognitive tasks,stride length of healthy leg side and the swing phase proportion of affected leg side swing was decreased,and the SI of the swing phase proportion decreased(P<0.05).Conclusions Community stroke patients mainly deal with cognitive task interference by reducing walking speed,reducing step length,reducing swing phase proportion,increasing step width and support phase proportion,and changing gait patterns.For gait stability,the intervention of high-load cognitive tasks will increase the asymmetry degree of swing proportion of community stroke patients and reduce their gait stability.

关 键 词：脑卒中 双任务介入 对称性 步态稳定性 

分 类 号：R318.01[医药卫生—生物医学工程]