老年正常压力脑积水患者与脑卒中患者三维步态参数的差异性研究

Difference of 3-dimensional Gait Parameters between the Elderly Patients with Normal Pressure Hydrocephalus and the Patients with Hemiplegia after Stroke

中文关键词: 正常压力脑积水  脑卒中  三维步态参数差异性

英文关键词: normal pressure hydrocephalus  stroke  3-dimensional gait parameter difference

中文摘要:

      目的 通过三维运动采集与分析系统对老年正常压力脑积水患者和脑卒中后偏瘫患者步态参数差异性进行研究.方法 选取9例老年正常压力脑积水患者和8例脑卒中后偏瘫患者进行三维步态数据采集,并分析对比2种步态的差异.结果 相对于脑卒中患者,正常压力脑积水患者表现出更小的步幅(P＜0.05)且步态周期总时间、支撑相时间、摆动相时间均减小(P＜0.05);运动学参数中髋关节最大伸展角度、最大外展角度以及髋关节矢状面活动范围均减小(P＜0.05),正常压力脑积水患者触地瞬间膝关节屈角小于脑卒中患者(P＜0.05),而膝关节最大外翻角度、最大外旋角度以及冠状面活动范围均大于脑卒中患者(P＜0.05).动力学参数中脑卒中患者表现出更大的垂直力峰值(P＜0.05)和膝关节外翻力矩峰值(P＜0.05),而躁关节跖屈力矩峰值、内翻力矩峰值小于正常压力脑积水患者(P＜0.05).结论 正常压力脑积水患者与脑卒中患者三维步态参数的差异性主要体现在时空参数,髋、膝关节的运动学参数和踝关节动力学参数.相对于脑卒中患者,正常压力脑积水患者步态异常的双侧性、时空参数的异常以及踝关节力矩的差异可能是其失衡跌倒发生率较高的原因.

英文摘要:

      Objective To study the difference in gait parameters between the elderly patients with normal pressure hydrocephalus and the patients with hemiplegia after stroke by 3-dimensional motion analysis system.Methods 3-dimensional gait data of 9 elderly patients with normal pressure hydrocephalus and 8 patients with hemiplegia after stroke were collected and the difference between the 2 gaits was analyzed.Results Compared with the stroke patients,the patients with normal pressure hydrocephalus showed smaller stride (P＜0.05) and decreased total gait cycle time,support phase,swing phase time (P＜0.05);the maximal extension angle of the hip joint,the maximum abduction angle and the sagittal ROM of hip reduced significantly (P＜0.05);the knee angles of initial contact reduced significantly (P＜0.05) while the maximum abduction angle of knee and the maximum external rotation angle of knee and the frontal ROM of knee increased significantly (P＜0.05);in dynamic parameters,the patients with stroke showed greater vertical force peak (P＜0.05) and the peak value of the abduction of the knee joint (P＜0.05);the peak value of the plantar flexion torques and the peak value of the varus torques were significantly lower than those of the elderly patients with normal pressure hydrocephalus (P＜0.05).Conclusions Differences of three-dimensional gait analysis between elderly patients with normal pressure hydrocephalus and patients with hemiplegia after stroke mainly exist in temporal-spatial parameters and kinematic parameters of the hip and knee while in kinetic parameters,for patients with stroke,the bilateral gait abnormity,abnormity of temporal-spatial parameters and the difference of ankle joint torque may be the cause for imbalances and high occurrence of fall.