中風患者站立穩定度與行走能力之相關性

The Relation Between Standing Stability and Walking Ability in Post-Stroke Patients

陳瓊玲(Chiung-Ling Chen) ； 楊國德(Kwok-Tak Yeung) ； 劉秀之(Hsiu-Chih Liu)

《職能治療學會雜誌》 20卷 (2002/11) Pp. 107-116

https://doi.org/10.6594/JTOTA.2002.20.09

摘要

Postural instability and walking disability are common problems among patients with hemiplegia due to a cerebrovascular accident (CVA). In the literature, there are a few studies investigated the relationship between standing balance and walking performance. Various types of subjects and postural stability measures as well as different walking parameters have been used in those studies. Thus, these factors may have contributed to the varying results reported. In addition, few studies have focused on the performance of stroke patients. This study quantitatively examines the relationship of standing stability measures to walking ability in post-stroke patients.
Twenty-two CVA patients participated in this study (160-male, 6-female), with a mean age of 56.1± 9.6years. The median interval between onset and investigation was 13 months. The Computer Dyno Graphy was used for measuring the ground reaction force under the feet while standing and walking. Patents were tested randomly in three conditions that included quiet standing, weight shifting and walking. Pearson product-moment correlation was used to determine the correlations among all the variables.
The results showed that in standing stability measures, weight bearing through the affected leg after weight shifting to the affected side was highly correlated with the weight distribution through the affected leg (r = .62, p＜ .01) and lateral weight shifting (r = .72, p＜ .01). In addition, lateral weight shifting was highly correlated with anterior-posterior weight shifting (r = .63, p＜ .01). Regarding postural stability and walking variables, only lateral weight shifting was significantly correlated with walking velocity (r = .48, p＜ .05). As to walking ability, only walking velocity was significantly correlated with intra-limb coordination (r = .59,p＜ .01). These results indicated that the variables among static and dynamic stability are not all related. It is suggested that balance consists of various dimensions; therefore, balance training for stroke patients should include both static and dynamic stability training. In addition, it was evident that lateral weight shifting was significantly correlated with walking velocity. The effects of lateral weight shifting training on walking ability of patients with CVA warrant further investigation.

關鍵字

中風患者,姿勢,行走能力

並列摘要

Postural instability and walking disability are common problems among patients with hemiplegia due to a cerebrovascular accident (CVA). In the literature, there are a few studies investigated the relationship between standing balance and walking performance. Various types of subjects and postural stability measures as well as different walking parameters have been used in those studies. Thus, these factors may have contributed to the varying results reported. In addition, few studies have focused on the performance of stroke patients. This study quantitatively examines the relationship of standing stability measures to walking ability in post-stroke patients.
Twenty-two CVA patients participated in this study (160-male, 6-female), with a mean age of 56.1± 9.6years. The median interval between onset and investigation was 13 months. The Computer Dyno Graphy was used for measuring the ground reaction force under the feet while standing and walking. Patents were tested randomly in three conditions that included quiet standing, weight shifting and walking. Pearson product-moment correlation was used to determine the correlations among all the variables.
The results showed that in standing stability measures, weight bearing through the affected leg after weight shifting to the affected side was highly correlated with the weight distribution through the affected leg (r = .62, p＜ .01) and lateral weight shifting (r = .72, p＜ .01). In addition, lateral weight shifting was highly correlated with anterior-posterior weight shifting (r = .63, p＜ .01). Regarding postural stability and walking variables, only lateral weight shifting was significantly correlated with walking velocity (r = .48, p＜ .05). As to walking ability, only walking velocity was significantly correlated with intra-limb coordination (r = .59,p＜ .01). These results indicated that the variables among static and dynamic stability are not all related. It is suggested that balance consists of various dimensions; therefore, balance training for stroke patients should include both static and dynamic stability training. In addition, it was evident that lateral weight shifting was significantly correlated with walking velocity. The effects of lateral weight shifting training on walking ability of patients with CVA warrant further investigation.

並列關鍵字

stroke,posture,walking