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脑卒中偏瘫患者坐、站过程中下肢对称性与压力中心摇摆的相关性分析

杨 凯, 李 猛, 周 鲁星, 孟庆 华*

摘要

脑卒中偏瘫患者体位不对称是脑卒中继发偏瘫后最常见的运动缺陷,在坐、站转移过程中由于平衡能力下降,压
力中心摇摆速度也会增加,卒中患者要比非卒中患者跌倒的风险更大,那么下肢的对称性对压力中心摇摆是否产生相应关
联的影响是本文要探究的主题。目的:探究设计:基于 Visual3D 数据分析软件配合红外动作捕捉系统以及测力台测得的数
据进行前瞻性研究。环境:以医院为基础的康复单位。患者:十五例脑卒中偏瘫患者。方法:分别通过两个 Kistler 测力平
台和一个 Qualisys 系统 (12 个高分辨率摄像头 ) 对偏瘫患者进行实验室坐、站测量。偏瘫患者穿戴可识别的 mark 点,在测
力台上进行坐、站转移的动作。主要观察指标:坐站转移过程的持续时间、力量上升率;髋、膝、踝关节屈伸力矩的比值;
压力中心的摇摆(cop)、双侧下肢负重的对称性。结果:髋、膝关节屈伸力矩对称性与 COP 面积以及 COP 移动轨迹长
呈现负相关,与力量上升率呈现正相关;踝关节屈伸力矩对称性与 COP 面积、轨迹长、力量上升率没有明显的相关性;
负重对称性与力量上升率呈正相关。结论:偏瘫患者下肢间的同步对称性的增加减少了 COP 面积增加以及 COP 位移轨迹
的增加,并且在坐站过程中增加了力量上升率。

关键词

坐站转移;脑卒中偏瘫;运动学;动力学;下肢对称性;压力中心

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