背景:从非侧面进入开口的高碰撞率和频率与中风个体的碰撞有关。
目的:确定中风个体走过狭窄开口时与避免碰撞行为相关的因素。
方法:亚急性或慢性中风的参与者穿过狭窄的开口,必须避免与障碍物碰撞。病理生理学进行多元回归分析,运动功能,和判断能力作为预测变量;碰撞率和从非侧面进入开口的频率是结果变量。
结果:纳入61名符合资格的卒中患者,年龄为63±12岁。30名参与者碰撞两次或更多次,37名参与者从非麻痹侧进入开口。较高的碰撞发生率与较慢的TimedUp和Go测试以及左右摇摆有关(赔率比,1.2和5.6;95%置信区间,1.1-1.3和1.3-28.2;p分别为.008和.025)。从非麻痹侧进入与丘脑病变有关,左侧偏瘫,和Brunnstrom第三阶段或更低(赔率比,6.6、8.7和6.7;95%置信区间,1.3-52.5、2.5-36.5和1.2-57.5;分别为p=.038、.001和.048)。
结论:步行能力与避免障碍物碰撞有关,而病理生理特征和瘫痪程度与身体哪一侧先进入开口的偏好有关。改善行走能力的干预措施可以改善防撞。介入期间的回避行为根据病变位置而变化。
BACKGROUND: High collision rates and frequency of entering the opening from non-paretic sides are associated with collision in individuals with stroke.
OBJECTIVE: To identify factors associated with collision avoidance behavior when individuals with stroke walked through narrow openings.
METHODS: Participants with subacute or chronic stroke walked through a narrow opening and had to avoid colliding with obstacles. Multiple regression analyses were conducted with pathophysiology, motor function, and judgment ability as predictor variables; collision rate and frequency of entering the opening from non-paretic sides were outcome variables.
RESULTS: Sixty-one eligible individuals with stroke aged 63±12 years were enrolled. Thirty participants collided twice or more and 37 entered the opening from the non-paretic side. Higher collision occurrence was associated with slower Timed Up and Go tests and left-right sway (odds ratios, 1.2 and 5.6; 95% confidence intervals, 1.1-1.3 and 1.3-28.2; p = .008 and.025, respectively). Entering from non-paretic sides was associated with lesions in the thalamus, left-sided hemiplegia, and Brunnstrom stage 3 or lower (odds ratios, 6.6, 8.7, and 6.7; 95% confidence intervals, 1.3-52.5, 2.5-36.5, and 1.2-57.5; and p = .038,.001, and.048, respectively).
CONCLUSIONS: Walking ability is associated with avoiding obstacle collision, while
pathophysiological characteristics and degree of paralysis are associated with a preference for which side of the body enters an opening first. Interventions to improve walking ability may improve collision avoidance. Avoidance behavior during intervention varies depending on the lesion position.