脑梗死患者步行中身体质心和压力中心轨迹空间关系的动态平衡研究

关键词：脑梗死  三维运动生物力学  身体质心  压力中心  动态平衡

Keywords:cerebral infarction  three-dimension  centre of mass  centre of pressure  dynamic balance

摘要：

      摘要 目的:通过对脑梗死患者平地步行中全身三维运动生物力学中身体质心(COM)和压力中心(COP)空间轨迹的分析，探讨脑梗死偏瘫患者动态平衡特点，为脑梗死患者步态康复和步行安全等提供指导。 方法：选择首次脑梗死后可以独立步行10m以上的单侧偏瘫患者16例作为实验组，相匹配的正常中老年人20例为对照组。采用Vicon Nexus和AMT OR6-7进行平地步行时全身三维运动学和动力学检测和处理，用C-Motion Visual 3D分析软件进行COM和COP分析。 结果：实验组和对照组比较，脑梗死患者在水平面内外侧（ML）COP-COM 差值与健康老年人比较差异有显著性意义（P＜0.05），其侧向摆动幅度明显增加。矢状面上足触地和离地时前后（AP）COP-COM差值与健康老年人比较差异也有显著性意义（P＜0.05），但其前后偏离幅度减小。脑梗死患者健侧和患侧COP-COM比较差异无显著性（P＞0.05）。 结论：①全身体表定位的三维运动生物力学检测可以为脑梗死患者提供动态量化平衡评估；②脑梗死患者平地步行中ML方向身体质心偏离压力中心距离大于正常中老年人，其侧向平衡较正常中老年人差。

Abstract:

      Abstract Objective: To analyze the spatial relationship between centre of mass(COM) and centre of pressure(COP) trajectories in whole body three-dimensional biomechanics of patients with cerebral infarction during ground walking and to explore the characteristics of dynamic balance with hemiplegic gait to guide the safety walking and decreasing the risk factors of falling. Method: Sixteen patients after first cerebral infarction with unilateral hemiplegia were recruited. These patients were accorded with the criteria that the subjects can walk 10m independently. Twenty healthy elder matched subjects were selected as control group. Vicon system with force plate form was used in accordance with Plug In Gait Full Body software, COM and COP were analysed with C-Motion Visual 3D software. Result: Compared to the control group, there were significant differences(P＜0.05) of COP-COM in medio-lateral (ML) directions and antero-posterior(AP) directions. The sway lengths of ML were larger and that of AP were less in stroke patient. Conclusion: ①Three-dimensional motion biomechanics with full body markers located can be used for an assessment of dynamic balance in stroke patients. ②Patients with cerebral infarction have larger sway in medical-lateral direction, and poorer balance in medio-lateral direction than healthy older people.