Analysis of gait characteristics of swing phase clearance disorder in stroke patients with foot drop

doi:10.3877/cma.j.issn.2095-123X.2021.06.007

Abstract

Abstract:

Objective

To study the effect of clearance disorder on balance and walking function in stroke patients with hemiplegic foot drop by using three-dimensional gait system.

Methods

Thirty cases of stroke patients with hemiplegic foot drop in the Department of Rehabilitation Medicine of the Affiliated Hefei Hospital of Anhui Medical University from November 2019 to March 2021 were selected as the observation group. According to the principle of consistent with the left and right sides of the lower limbs on the hemiplegic side and unbiased side, 30 healthy volunteers were selected as the control group. According to the principle corresponding to the left and right lower limbs of hemiplegic side, they were divided into control group 1 and control group 2. The gait parameters, minimum toe clearance (MTC), balance and lower limb motor function parameters of the two groups were compared, and the correlation between MTC and balance and lower limb motor function was analyzed.

Results

In the observation group, as compared with the non-hemiplegic side, stride frequency, maximum hip flexion, hip extension, knee flexion, ankle dorsiflexion angle, the range of motion (ROM) of hip, knee and ankle, MTC in the hemiplegic side decreased significantly (P<0.05), while the percentage of swing phase, maximum knee extension and ankle planter flexion angle increased significantly (P<0.05). Compared with the control group 1, step speed, length and stride frequency, percentage of swing phase, maximum hip flexion, hip extension, knee flexion, ankle dorsiflexion angle, the ROM of hip, knee and ankle, MTC decreased significantly of the hemiplegic side in the observation group, while maximum knee extension and ankle planter flexion angle increased significantly (P<0.05). Compared with the control group 2, step speed, length and stride frequency, percentage of swing phase, maximum hip extension, knee flexion, ankle planter flexion angle, ROM of hip, knee and ankle, MTC decreased significantly (P<0.05), while maximum knee extension increased significantly (P<0.05). MTC of hemiplegic side in the observation group was correlated with Berg and FMA scores (P<0.05).

Conclusion

In patients with foot drop, the clearance ability, balance function and lower limb motor function are decreased. MTC of hemiplegic side was correlated with balance and lower limb motor function.

Key words: Stroke, Foot drop, Three-dimensional gait, Toe clearance, Balance

Hongyu Zhang, Qing Xia, Lu Wei, Lingling Du, Xiumin Wang. Analysis of gait characteristics of swing phase clearance disorder in stroke patients with foot drop[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(06): 353-357.

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Figures/Tables 3

References 23

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组别	例数	年龄（岁，Mean±SD）	身高（cm，Mean±SD）	体质量（kg，Mean±SD）	性别		疾病性质		偏瘫侧
组别	例数	年龄（岁，Mean±SD）	身高（cm，Mean±SD）	体质量（kg，Mean±SD）	男	女	脑出血	脑梗死	左	右
观察组	30	51.97±12.62	166.7±6.78	67.33±7.70	19	11	14	16	16	14
对照组	30	53.17±7.12	165.3±7.02	65.17±7.51	19	11	-	-	-	-
t/χ²值		0.626	-1.463	-1.001	0.000		-		-
P值		0.536	0.154	0.325	1.000		-		-

组别	例数	年龄（岁，Mean±SD）	身高（cm，Mean±SD）	体质量（kg，Mean±SD）	性别		疾病性质		偏瘫侧
组别	例数	年龄（岁，Mean±SD）	身高（cm，Mean±SD）	体质量（kg，Mean±SD）	男	女	脑出血	脑梗死	左	右
观察组	30	51.97±12.62	166.7±6.78	67.33±7.70	19	11	14	16	16	14
对照组	30	53.17±7.12	165.3±7.02	65.17±7.51	19	11	-	-	-	-
t/χ²值		0.626	-1.463	-1.001	0.000		-		-
P值		0.536	0.154	0.325	1.000		-		-

参数	对照组（n=30）				观察组（n=30）
参数	组1	组2	t值	P值	偏瘫侧	非偏瘫侧	t值	P值
步速（m/s）	0.96±0.19	0.97±0.17	-0.571	0.573	0.34±0.12^a	0.34±0.12^b	0.744	0.463
步长（m）	0.54±0.07	0.56±0.08	-1.876	0.071	0.27±0.09^a	0.27±0.10^b	-0.271	0.788
步频（steps/min）	105.48±12.19	105.13±10.56	0.342	0.735	68.88±12.23^a	77.35±16.64^b	-3.574	0.001
摆动相百分比（%）	45.22±2.11	45.21±2.27	0.023	0.982	37.32±6.54^a	31.28±7.19^b	4.692	<0.001
髋关节ROM（°）	41.33±3.47	40.47±4.29	0.837	0.410	23.09±2.90^a	34.21±3.71^b	-13.646	<0.001
最大屈髋（°）	38.82±3.24	38.27±3.24	0.676	0.505	30.18±3.22^a	36.60±3.68	-7.298	<0.001
最大伸髋（°）	2.51±2.05	2.20±1.76	-0.595	0.556	-7.09±2.77^a	-2.39±2.32^b	7.017	<0.001
膝关节ROM（°）	61.70±5.65	62.68±4.51	-1.103	0.279	30.28±4.79^a	45.42±4.97^b	-10.622	<0.001
最大屈膝（°）	60.76±5.91	61.55±4.61	-0.823	0.417	35.52±4.15^a	47.23±5.19^b	-9.072	<0.001
最大伸膝（°）	-0.94±3.33	-1.14±3.10	0.267	0.785	5.24±2.02^a	1.81±3.17^b	5.795	<0.001
踝关节ROM（°）	25.38±2.50	26.00±3.31	-0.877	0.387	11.62±2.70^a	17.82±4.26^b	-5.169	<0.001
最大踝背屈（°）	8.14±2.3	8.17±2.62	-0.071	0.944	-1.37±2.80^a	7.05±2.23	-12.967	<0.001
最大踝跖屈（°）	12.24±2.04	12.91±2.53	1.104	0.279	14.00±2.36^a	10.76±3.75^b	-3.547	<0.001
MTC （mm）	26.88±3.18	26.80±3.30	0.233	0.817	12.01±3.36^a	22.38±5.51^b	-9.137	<0.001

参数	对照组（n=30）				观察组（n=30）
参数	组1	组2	t值	P值	偏瘫侧	非偏瘫侧	t值	P值
步速（m/s）	0.96±0.19	0.97±0.17	-0.571	0.573	0.34±0.12^a	0.34±0.12^b	0.744	0.463
步长（m）	0.54±0.07	0.56±0.08	-1.876	0.071	0.27±0.09^a	0.27±0.10^b	-0.271	0.788
步频（steps/min）	105.48±12.19	105.13±10.56	0.342	0.735	68.88±12.23^a	77.35±16.64^b	-3.574	0.001
摆动相百分比（%）	45.22±2.11	45.21±2.27	0.023	0.982	37.32±6.54^a	31.28±7.19^b	4.692	<0.001
髋关节ROM（°）	41.33±3.47	40.47±4.29	0.837	0.410	23.09±2.90^a	34.21±3.71^b	-13.646	<0.001
最大屈髋（°）	38.82±3.24	38.27±3.24	0.676	0.505	30.18±3.22^a	36.60±3.68	-7.298	<0.001
最大伸髋（°）	2.51±2.05	2.20±1.76	-0.595	0.556	-7.09±2.77^a	-2.39±2.32^b	7.017	<0.001
膝关节ROM（°）	61.70±5.65	62.68±4.51	-1.103	0.279	30.28±4.79^a	45.42±4.97^b	-10.622	<0.001
最大屈膝（°）	60.76±5.91	61.55±4.61	-0.823	0.417	35.52±4.15^a	47.23±5.19^b	-9.072	<0.001
最大伸膝（°）	-0.94±3.33	-1.14±3.10	0.267	0.785	5.24±2.02^a	1.81±3.17^b	5.795	<0.001
踝关节ROM（°）	25.38±2.50	26.00±3.31	-0.877	0.387	11.62±2.70^a	17.82±4.26^b	-5.169	<0.001
最大踝背屈（°）	8.14±2.3	8.17±2.62	-0.071	0.944	-1.37±2.80^a	7.05±2.23	-12.967	<0.001
最大踝跖屈（°）	12.24±2.04	12.91±2.53	1.104	0.279	14.00±2.36^a	10.76±3.75^b	-3.547	<0.001
MTC （mm）	26.88±3.18	26.80±3.30	0.233	0.817	12.01±3.36^a	22.38±5.51^b	-9.137	<0.001

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