Marcha de orientación, una vía para mejorar las funciones cognitivas en el adulto mayor

La utilidad de la recreación física con carácter lúdico resulta un medio fundamental para mejorar la salud, las funciones cognitivas y la calidad de vida. A partir de un diagnóstico aplicado a una muestra de 19 adultos mayores, estos presentaron insuficiencias en los procesos de la memoria; en tal sentido, se comprobó que las propuestas de actividades físico-recreativas dirigidas a este grupo etario fueron muy generales, no atendieron las características morfofuncionales y estuvieron limitadas en la variedad de ofertas recreativas. La presente investigación tuvo como objetivo mejorar las funciones cognitivas, que se relacionan con la memorización, en los adultos mayores de la comunidad Matahambre, del municipio Songo la Maya, a través de la marcha de orientación. Se emplearon como métodos teóricos el analítico-sintético e inductivo-deductivo; y empíricos, el análisis documental, la observación, la encuesta y la entrevista que permitieron obtener los datos e informaciones necesarias para la correcta realización de la marcha de orientación al tomar en cuenta las características de este grupo poblacional. La propuesta demostró la marcha de orientación como una importante herramienta que estimuló las capacidades memorísticas y los recuerdos, al tomar en cuenta los gustos, preferencias, necesidades e intereses del adulto mayor, resultarles atractiva y permitirles recordar aspectos o emociones vitales de su vida personal.

A utilidade da recreação física de caráter recreativo é um meio fundamental para melhorar a saúde, as funções cognitivas e a qualidade de vida. A partir de diagnóstico aplicado a uma amostra de 19 idosos, estes apresentavam insuficiências nos processos de memória; Neste sentido, constatou-se que as propostas de atividades físico-recreativas dirigidas a esta faixa etária eram muito generalistas, não tinham em conta as características morfofuncionais e limitavam-se na variedade de ofertas recreativas. O objetivo desta pesquisa foi melhorar as funções cognitivas relacionadas à memorização em idosos da comunidade Matahambre, no município de Songo la Maya, por meio da caminhada de orientação. Os métodos analítico-sintético e indutivo-dedutivo foram utilizados como métodos teóricos; e empírica, análise documental, observação, inquérito e entrevista que permitiram obter os dados e informações necessários à correta implementação da marcha de orientação tendo em conta as características deste grupo populacional. A proposta demonstrou a caminhada de orientação como uma importante ferramenta que estimulou habilidades de memória e lembranças, ao levar em conta os gostos, preferências, necessidades e interesses do idoso, tornando-a atrativa para ele e permitindo-lhe relembrar aspectos vitais ou emoções de sua vida. vida pessoal.

The usefulness of physical recreation with a playful character for this group of people is a fundamental means to improve their health, their cognitive functions and their quality of life. From a diagnosis applied to a sample of 19 older adults, it was possible to know the insufficiencies in memoristic events that these subjects had. In this sense, it was also found that the proposal of physical-recreational activities aimed at this age group in the community are very general and do not take into account their morpho-functional characteristics. They are limited in terms of the variety of recreational offers for this population group. The objective of this research is to improve cognitive functions, which are related to memorization, in older adults of the "Matahambre" community of the Songo la Maya municipality through orientation walking. For the solution of the objective, theoretical methods such as: analytical-synthetic and inductive-deductive were used. Among the empirical methods, documentary analysis, observation, survey and interview were used to obtain the necessary data and information for the correct implementation of the orientation walk, taking into account the characteristics of this population group. The proposal showed that the orientation walk is an important tool that stimulates the memory and memory capacities of these people, by taking into account their tastes, preferences, needs and preferences.

Effects of Biomimetic Shoes on Healthy Young Children's Gait / Efeitos do uso de calçado biomimético na marcha de crianças típicas

Abstract Objective To compare the spatial-temporal parameters and walking kinematics of toddlers wearing biomimetic shoes, regular shoes (daily use owned shoes), and barefoot. Methods Spatial-temporal parameters (speed, step length, and stride width), the mean vertical displacement of the center of mass (COM), knee flexion peak, and maximal foot height were analyzed. Results Children were not different in biomimetic shoes and barefoot conditions on speed, step length, and COM vertical displacement. There was no difference among conditions on stride width and foot height. The knee flexion peak was greater in shod conditions than barefoot. The regular shoes showed greater COM vertical displacement than biomimetic shoes and barefoot. Conclusion The findings showed that shoes affected the walking pattern in young children, but a shoe with a biomimetic design had a lesser effect on the walking pattern.

Resumo Objetivo O objetivo deste trabalho foi comparar os parâmetros espaço temporais e cinemáticos da marcha de crianças típicas em três condições: descalças, usando calçados biomiméticos e, calçados de uso diário (não biomiméticos - próprios das crianças). Métodos Foram analisadas variáveis espaço temporais (velocidade, comprimento e largura da passada), deslocamento vertical do centro de massa (CM), pico de flexão do joelho e altura máxima do pé, coletados via avaliação tridimensional do movimento. Resultados Comparado com a condição descalça, o uso do calçado biomimético não foi estatisticamente diferente em relação a velocidade da marcha, comprimento da passada e altura do pé. A largura da passada e a altura do pé não foi diferente estatisticamente entre as condições estudadas. O pico de flexão do joelho foi maior nas condições com calçados comparado a condição descalça. Os calçados de uso diário apresentaram maior deslocamento vertical do COM do que nas condições com o calçado biomimético e descalço. Conclusão Os achados deste trabalho reafirmam que o uso do calçado influencia a marcha de crianças, especificamente na fase de desenvolvimento da marcha mas, que calçados com um design biomimético tem menores impactos no padrão de marcha das crianças.

Improving walking via real-time visual feedback after stroke in treadmill training (RE-VISIT): a protocol for randomized controlled trial / Melhorando a caminhada por meio de feedback visual em tempo real após acidente vascular cerebral em treinamento em esteira (RE-VISIT): um protocolo para ensaio clínico randomizado

BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating realtime visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.

CONTEXTO: Após o acidente vascular cerebral, a maioria dos pacientes frequentemente sofre redução da capacidade de caminhar e do equilíbrio. Restaurar a capacidade de caminhar e melhorar o equilíbrio são os principais objetivos da reabilitação do AVC. As esteiras são frequentemente usadas em ambientes clínicos para atingir esses objetivos. Está comprovado que adicionar dimensões ao feedback visual, além do espelho para visão frontal em tempo real, melhora a marcha. É, portanto, importante projetar feedbacks visuais adicionais em tempo real no treinamento em esteira, em particular para o lado envolvido na visão sagital. OBJETIVO: O objetivo deste estudo é testar se o feedback visual sagital em tempo real durante o treinamento em esteira é superior ao programa de treinamento em esteira com feedback de espelho convencional de intensidade equivalente na melhoria da velocidade de caminhada e equilíbrio após acidente vascular cerebral. MÉTODOS/ DESENHO: O ensaio RE-VISIT (feedback visual em tempo real após acidente vascular cerebral no treinamento em esteira) está registrado no Registro de Ensaios Clínicos da Índia (CTRI/2023/10/058299). Neste ensaio de controle randomizado de dois braços, que será um estudo cego, 42 sobreviventes de AVC elegíveis em reabilitação serão alocados aleatoriamente (proporção de 1:1) para feedback sagital visual em tempo real junto com grupo de espelho frontal (experimental) ou apenas Grupo de treinamento em esteira com espelho frontal (controle), todos os participantes receberão 15 sessões de treinamento em esteira por até 15 minutos em uma velocidade segura e autosselecionada durante 5-6 semanas. O grupo RE-VISIT (experimental) receberá feedback visual em tempo real da visão sagital da trajetória dos membros inferiores envolvidos, juntamente com a visão rotineira do espelho frontal durante o treinamento em esteira e será solicitado a modificar seu padrão de marcha. O grupo de controle receberá treinamento de caminhada em esteira apenas com o feedback rotineiro da visão do espelho frontal. Avaliações clínicas e de marcha serão realizadas no início do estudo, imediatamente após a sessão final de treinamento e na 9ª semana durante o acompanhamento. As medidas de resultados de interesse são a velocidade de caminhada (primária) e o equilíbrio (secundário), que serão medidos antes da linha de base, após a 15ª sessão de treinamento e na 9ª semana após o treinamento. DISCUSSÃO: este ensaio REVISIT fornecerá insights e contribuirá para a inovação e modificações existentes na incorporação de feedbacks visuais em tempo real durante o treinamento em esteira na reabilitação da marcha pós-AVC. As descobertas ajudarão no melhor desenho de um programa de reabilitação da marcha com esteira para indivíduos pós-AVC para melhorar a velocidade de caminhada e o equilíbrio para aqueles que têm maiores dificuldades na deambulação comunitária. Prevemos que aqueles no treinamento REVISIT demonstrarão melhor capacidade de caminhada.

Variação da velocidade de marcha e fatores clínicos associados em pessoas idosas da atenção primária à saúde: estudo longitudinal / Variation in gait speed and associated clinical factors in elderly people in primary health care: longitudinal study

Resumo: analisar a variação da velocidade da marcha e os fatores clínicos associados em pessoas idosas da Atenção Primária à Saúde, no período mínimo de dois anos. Materiais e método: estudo longitudinal prospectivo, do tipo quantitativo, subprojeto do projeto de pesquisa matriz intitulado "As variações da fragilidade física e da funcionalidade de idosos da atenção primária à saúde", desenvolvido com 389 idosos da atenção primária à saúde. As coletas de dados foram realizadas nos anos de 2019 (1ª onda) e 2022 (2ª onda), com idosos assistidos em uma Unidade Básica de Saúde de Curitiba-PR. Aplicou-se questionário com variáveis sociodemográficas e clínicas, incluindo autorrelato de agravos em saúde e história pregressa; teste Timed Up and Go para verificar o risco de queda; e avaliação do fenótipo da fragilidade física, com destaque para a velocidade da marcha. Os dados foram analisados de forma descritiva, a partir da distribuição de frequência absoluta e relativa, média e desvio padrão; bem como análise inferencial por meio de testes não paramétricos qui-quadrado, Wilcoxon Signed Rank e Exato de McNemar, para amostras pareadas, a fim de comparação entre os dois momentos (1ª e 2ª avaliação); e regressão logística para propor modelo preditivo, o qual considerou a entrada de variáveis que apresentaram p-valor =0,20 (técnica enter hierárquico), permanecendo no modelo as variáveis que apresentaram valor de p=0,05 ou que ajustassem o modelo. Considerou-se o nível de significância de 5%. O estudo recebeu parecer favorável do Comitê de Ética em Pesquisa. Resultados: a prevalência de VM reduzida na 1ª onda (n=389) foi de 20,8% (n=81). Com relação à 2ª onda (n= 128), 21 (16,4%) participantes apresentaram VM reduzida, dos quais 13 (61,9%) já dispunham dessa condição na baseline e 8 (6,25%) da amostra apresentaram redução da VM durante o seguimento (incidência). Ainda, 8 (7,5%) idosos com VM reduzida na 1ª onda apresentaram melhora desse parâmetro , indicando VM preservada na 2ª onda. Observou-se acréscimo na média de velocidade de marcha dos idosos de 0,04m/s durante o seguimento (de 1,03 m/s para 1,07m/s), no entanto, a variação não foi estatisticamente significativa (p=1,00). Os fatores clínicos, embora associados à VM reduzida na 1ª onda de avaliação, não apresentaram relação estatisticamente significativa à mudança na VM dos idosos durante o seguimento do estudo. O modelo preditivo de VM reduzida indicou que as variáveis comprometimento cognitivo sugestivo (OR:19,62; IC95%=1,93-209,92; p=0,014), força de preensão manual (OR:1,97; IC95%=1,04-3,71; p=0,036) risco de queda (OR:4,07; IC95%=2,27-7,28; p<0,001), histórico de quedas no último ano (OR:1,81; IC95%=0,99-3,26; p=0,050), problemas metabólicos (OR:1,97; IC95%=1,09-3,55; p=0,024), auditivo (OR:0,33; IC95%=0,14-0,80; p=0,013) e cardiovascular (OR:2,08; IC95%=1,02-4,26; p=0,044), aumentaram as chances de as pessoas idosas apresentarem VM reduzida. Conclusão: não houve variação significativa da VM no período investigado e os fatores clínicos se mostraram associados à VM reduzida apenas na 1ª onda de avaliação. É importante que a equipe de saúde da atenção primária desenvolva ações de acompanhamento, bem como de rastreio da velocidade da marcha e das condições clínicas relacionadas à saúde, com vistas a evitar a progressão da síndrome da fragilidade das pessoas idosas.

Abstract: to analyze the variation in gait speed and associated clinical factors in elderly people in Primary Health Care, over a minimum period of two years. Materials and method: prospective longitudinal study, quantitative, subproject of the main research project entitled "Variations in physical frailty and functionality of elderly people in primary health care", developed with 389 elderly people in primary health care. Data collection was carried out in 2019 (1st wave) and 2022 (2nd wave), with elderly people cared for in a Basic Health Unit in Curitiba-PR. A questionnaire was applied with sociodemographic and clinical variables, including self-report of health problems and past history; Timed Up and Go test to check the risk of falling; and assessment of the physical frailty phenotype, with emphasis on gait speed. The data were analyzed descriptively, based on absolute and relative frequency distribution, mean and standard deviation; as well as inferential analysis using non-parametric chi-square tests, Wilcoxon Signed Rank and McNemar's exact tests, for paired samples, in order to compare the two moments (1st and 2nd assessment); and logistic regression to propose a predictive model, which considered the entry of variables that presented a p-value =0.20 (hierarchical enter technique), with variables that presented a p-value =0.05 or that adjusted the model remaining in the model. A significance level of 5% was considered. The study received a favorable opinion from the Research Ethics Committee. Results: the prevalence of reduced MV in the 1st wave (n=389) was 20.8% (n=81). In relation to the 2nd wave (n= 128), 21 (16.4%) participants presented reduced MV, of which 13 (61.9%) already had this condition at baseline and 8 (6.25%) of the sample presented a reduction of MV during follow-up (incidence). Furthermore, 8 (7.5%) elderly people with reduced MV in the 1st wave showed improvement in this parameter, indicating preserved MV in the 2nd wave. An increase in the elderly's average walking speed of 0.04 m/s was observed during the follow-up (from 1.03 m/s to 1.07 m/s), however, the variation was not statistically significant (p=1 ,00). Clinical factors, although associated with reduced MV in the 1st wave of evaluation, did not present a statistically significant relationship to the change in the elderly's MV during the study follow-up. The predictive model of reduced MV indicated that the variables suggestive cognitive impairment (OR:19.62; CI95%=1.93-209.92; p=0.014), handgrip strength (OR:1.97; CI95%= 1.04-3.71; p=0.036) risk of falling (OR:4.07; 95%CI=2.27-7.28; p<0.001), history of falls in the last year (OR:1.81; CI95%=0.99-3.26; p=0.050), metabolic problems (OR:1.97; CI95%=1.09-3.55; p=0.024), auditory (OR:0.33; CI95 %=0.14-0.80; p=0.013) and cardiovascular (OR:2.08; 95%CI=1.02-4.26; p=0.044), increased the chances of elderly people having reduced MV. Conclusion: there was no significant variation in MV during the period investigated and clinical factors were associated with reduced MV only in the 1st wave of evaluation. It is important that the primary care health team develops follow-up actions, as well as tracking the speed of MV. gait and healthrelated clinical conditions, with a view to preventing the progression of frailty syndrome in elderly people.

Influence of the use of a walking diary on mobility in patients in cardiac rehabilitation phase 1: a randomized clinical trial / Influência do uso do diário de caminhada na mobilidade de pacientes em reabilitação cardíaca fase 1: ensaio clínico randomizado

INTRODUCTION: Inpatient rehabilitation is extremely important for patients recovering from cardiac surgery. Although a walking diary is routinely used in clinical practice, it has yet to be adequately tested and reported in the literature. OBJECTIVES: To establish whether the use of a walking diary affects the number of steps taken following cardiac surgery and whether this is related to the patient's level of cardiac anxiety. METHODS: An open, controlled, randomized clinical trial was conducted with adult patients submitted to elective valve and/or coronary surgery, who had no motor impairment. All the participants used a pedometer to register the number of steps taken over five consecutive days in the hospital. Twenty-nine individuals were randomized to create an intervention group that used the walking diary as treatment strategy, while twenty-three were allocated to a control group. The Mann-Whitney test was used to compare the number of steps between the two groups, while Spearman's correlation coeficiente was performed to evaluate the relationship between the number of steps and the level of cardiac anxiety. Statistical significance was defined as p<0.05. RESULTS: The groups were similar regarding their demographic, clinical and surgical characteristics. There was no difference between the groups regarding the total number of steps taken: control group=1,496 (477.5 - 2992.5) vs. Intervention group=1,468.5 (494.2 - 2,678) (p=0.902). CONCLUSION: The use of the walking diary had no effect on the number of steps taken and was unassociated with the level of cardiac anxiety in inpatients following cardiac surgery.

INTRODUÇÃO: A reabilitação hospitalar é extremamente importante para pacientes em recuperação de cirurgia cardíaca. Embora o diário de caminhada seja rotineiramente utilizado na prática clínica, ele ainda não foi adequadamente testado e relatado na literatura. OBJETIVOS: Estabelecer se o uso do diário de caminhada afeta o número de passos dados após cirurgia cardíaca e se isso está relacionado ao nível de ansiedade cardíaca do paciente. MÉTODOS: Foi realizado um ensaio clínico aberto, controlado e randomizado com pacientes adultos submetidos à cirurgia eletiva de valva e/ou coronária, sem comprometimento motor. Todos os participantes usaram um pedômetro para registrar o número de passos dados ao longo de cinco dias consecutivos de internação. Vinte e nove indivíduos foram randomizados para um grupo intervenção para usar o diário de caminhada como estratégia de tratamento, enquanto vinte e três foram alocados para um grupo controle. O teste de Mann-Whitney foi utilizado para comparar o número de passos entre os dois grupos, enquanto o coeficiente de correlação de Spearman foi realizado para avaliar a relação entre o número de passos e o nível de ansiedade cardíaca. A significância estatística foi definida como p < 0,05. RESULTADOS: Os grupos foram semelhantes quanto às características demográficas, clínicas e cirúrgicas. Não houve diferença entre os grupos quanto ao número total de passos dados: grupo controle=1.496 (477,5 - 2.992,5) vs. grupo intervenção=1.468,5 (494,2 - 2.678) (p=0,902). CONCLUSÃO: O uso do diário de caminhada não teve efeito no número de passos dados e não foi associado ao nível de ansiedade cardíaca em pacientes internados após cirurgia cardíaca.

Clinical Observation on Abdominal Penetrating Moxibustion Combined with Acupuncture at Four Chong Acupoints for the Treatment of Stroke in the Convalescent Stage / 广州中医药大学学报

Objective To observe the effects of abdominal penetrating moxibustion combined with acupuncture at the"four chong points"on balance,walking function and trunk control in patients recovering from stroke.Methods Seventy-eight patients recovering from stroke were randomly divided into an observation group and a control group,with 39 patients in each group.The control group was given conventional rehabilitation exercises,while the observation group was given abdominal penetrating moxibustion combined with acupuncture at the"four chong points"on the basis of the control group.Both groups were treated for 2 consecutive months.After 2 months of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Berg Scale score and the Timed Up and Go Test(TUGT)were observed before and after treatment.The changes in the National Institutes of Health Stroke Scale(NIHSS)scores were compared before and after treatment between the two groups.The Sheikh Trunk Control Scale scores were also evaluated.Results(1)The total effective rate of the observation group was 94.87%(37/39),and the total effective rate of the control group was 80.00%(31/39),and the efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the Berg scores of the patients in the two groups were significantly increased(P＜0.05),and the Berg scores of the observation group were higher than those of the control group,and the difference was statistically significant(P＜0.05).(3)After treatment,the TUGT time and NIHSS score of patients in the two groups were significantly improved(P＜0.05),and the TUGT time of the observation group was shorter than that of the control group,and the NIHSS score was lower than that of the control group,and the difference was statistically significant(P＜0.05).(4)After treatment,the Sheikh trunk control scores of the two groups were significantly increased(P＜0.05),and the Sheikh trunk control score of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Abdominal penetrating moxibustion method combined with acupuncture at the four chong points for the treatment of stroke recovery can effectively restore the patients'balance and walking function,improve the patients'trunk control ability,and the therapeutic effect is precise.

Efficacy of rehabilitation exoskeleton robots on post-stroke lower limb motor dysfunction:a Meta-analysis / 中国组织工程研究

OBJECTIVE:To systematically evaluate the efficacy of rehabilitation exoskeleton robots on the lower limb motor function of stroke patients using Meta-analysis and to compare the efficacy of different lower limb exoskeleton robots,so as to provide a theoretical basis for the scientific selection of suitable exoskeleton robots for patients with post-stroke lower limb motor dysfunction. METHODS:Computer searches of the Cochrane Library,PubMed,Web of Science,Embase,CNKI,VIP,and WanFang Data were conducted to collect randomized controlled clinical studies on exploring lower extremity rehabilitation exoskeleton robots to improve lower limb motor function in stroke patients published from database inception to November 2022.Two researchers conducted the literature search and screening.The quality of the included literature was evaluated using the Cochrane 5.1.0 risk of bias assessment tool and the Jadad scale.Meta-analysis was performed using RevMan 5.4 and Stata 17.0 software. RESULTS:(1)Finally 22 publications were included,involving 865 patients(n=436 in the test group and n=429 in the control group),and the Jadad score showed that all the included articles were of high quality.(2)Meta-analysis results showed that the exoskeleton robot significantly improved the Fugl-Meyer Assessment of Lower Extremity score(mean difference[MD]=2.63,95%confidence interval[CI]:1.87-3.38,P<0.05),Berg Balance Scale score(MD=3.62,95%CI:1.21-6.03,P<0.05),Timed Up and Go score(MD=-2.77,95%CI:-4.48 to-1.05,P<0.05)and step frequency score(MD=3.15,95%CI:1.57-4.72,P<0.05)in stroke patients compared with the control group.However,there was no significant improvement in the Functional Ambulation Category Scale score(MD=0.30,95%CI:-0.01 to 0.61,P>0.05)and 6-minute walk test score(MD=3.77,95%CI:-6.60 to 14.14,P>0.05).(3)Network Meta-analysis results showed that compared with the conventional rehabilitation therapy,both the level-walking exoskeleton(MD=10.23,95%CI:3.81-27.49,P<0.05)and the body-weight support exoskeleton(MD=33.66,95%CI:11.49-98.54,P<0.05)improved the Fugl-Meyer Assessment of Lower Extremity score.Compared with the conventional rehabilitation therapy,body-weight support exoskeleton significantly improved the Berg Balance Scale scores(MD=79.86,95%CI:2.34-2 725.99,P<0.05).In terms of Fugl-Meyer Assessment of Lower Extremity and Berg Balance Scale scores,the ranking results were body-weight support exoskeleton>level-walking exoskeleton>conventional rehabilitation therapy.Compared with the conventional rehabilitation therapy,level-walking exoskeleton significantly improved the Functional Ambulation Category Scale score(MD=1.38,95%CI:1.00-1.90,P<0.05)and body-weight support exoskeleton significantly improved the Timed Up and Go score(MD=0.07,95%CI:0.01-0.51,P<0.05).In terms of Functional Ambulation Category Scale and Timed Up and Go scores,the ranking results were level-walking exoskeleton>body-weight support exoskeleton>conventional rehabilitation therapy. CONCLUSION:Rehabilitation exoskeleton robots can improve balance,walking and activities of daily living in stroke patients,with body-weight support exoskeleton being more effective in improving lower limb motor function and balance and level walking exoskeleton being more effective in improving functional walking and transfer.

Changes in plantar pressure of subjects with different foot positions during walking and jogging after Kinesio taping / 中国组织工程研究

BACKGROUND:Kinesio taping is often used for the treatment of various sports injuries.The methods of foot and ankle sports taping are complex and diverse.Among them,Fascia taping is applicable to a wider range of people and can be used for different foot posture types,but it still lacks of practical verification,and its specific biomechanical role is not clear. OBJECTIVE:To observe the changes in plantar pressure characteristics of subjects with different foot positions during walking and jogging after Fascia taping. METHODS:Thirty-seven young healthy subjects were recruited from the Yantai campus of Binzhou Medical University to conduct the test.They were scored according to the foot posture index-six items version,and were divided into the supination foot group,the neutral foot group,and the pronation foot group.The static foot morphological indexes(including navicular drop,arch height index,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch)and the pressure-time integral of each foot zone during walking and jogging were collected and calculated respectively before and after Kinesio taping.The specific biomechanical mechanism of Fascia taping was analyzed. RESULTS AND CONCLUSION:(1)General data:There was no statistical difference among the three groups of subjects in general data,such as gender,height,and body mass index(P>0.05).Before taping,there was a significant difference in the foot morphological indexes and the areas of the outer front foot,midfoot,and hindfoot between different foot posture groups(P<0.01).(2)Static foot morphological indexes:After taping,there was no statistically significant difference between the groups in navicular drop,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch(P>0.05),while there was still a significant difference between the groups in the arch height index(P<0.05).In the supination foot group,the arch height index increased slightly,but there was no significant difference before and after taping(P>0.05).In the pronation foot group,the navicular drop and arch height flexibility-longitudinal arch was significantly reduced,and the arch height index was increased.There was a significant difference before and after taping(P<0.05).(3)The index of plantar pressure during walking:After taping,there was no significant difference between the three groups in the area of lateral forefoot and medial midfoot(P>0.05).In the pronation foot group,the lateral load of the forefoot increased after taping(P<0.05).In the supination position group,the load of the lateral forefoot and midfoot regions increased significantly(P<0.05),while the difference in the rear foot region was not significant(P>0.05).(4)The index of plantar pressure during jogging:After taping,there was no statistically significant difference between groups in the lateral forefoot(P>0.05).In the pronation foot group,the load of the medial forefoot increased significantly(P<0.05).In the supination position group,the load of the lateral forefoot,the middle foot and the rear foot region increased significantly(P<0.05).(5)The results showed that the Fascia taping was suitable for different foot postures.It could not only correct the static foot structure of subjects with different foot postures,but also regulate the abnormal plantar pressure distribution during the dynamic activities of walking and jogging,and the load of the midfoot,forefoot,and hindfoot in the supination and pronation posture tended to normal foot posture load level.

Mechanical performance and collapse risk prediction of avascular necrosis of femoral head under walking movement / 中国组织工程研究

BACKGROUND:Avascular necrosis of the femoral head is a refractory orthopedic disease that seriously affects the normal life of patients.Hip preservation is recommended for young patients due to the limited prosthesis longevity and revision.Accurate prediction of the mechanical properties of the necrotic area in the early stage and then intervention is the key to hip preservation. OBJECTIVE:To establish a dynamic contact mechanics finite element model of necrotic femoral head based on human hip CT data and predict effects of both necrotic volume magnitude and its position on biomechanics of the necrotic region under walking movement. METHODS:CT data of a volunteer were collected and then geometry model of the hip was rebuilt.Finite element model of the necrotic femoral head was established using the Abaqus software.Nine different necrotic femoral models were constructed by combined both three different necrotic volume magnitudes(small,medium and big volume)and three different necrotic positions(coincided with,medium deviated with and kept away from the line of the force).The Von Mises of the necrotic region for all models were predicted under both 3 000 N static load and dynamical loads of one whole ISO walking gait cycle.The collapse risk for all models was evaluated based on collapse criterion. RESULTS AND CONCLUSION:(1)More approaching of the necrotic region to the line of force and bigger collapse volume made the maximum Von Mises increasing.This also enlarged the collapse risk of the necrotic region.(2)For different load types,walking movement increased the maximum Von Mises of the necrotic region than that of the value under static load under the same necrotic volume and location.(3)In conclusion,dynamic load would result in increasing of the maximum Von Mises of the necrotic region comparing to static load during exercise.Therefore,the risk of local collapse will increase due to greater Von Mises.However,the overall collapse risk is lower than that of static load due to the dynamic change of bearing area.This factor should be carefully considered by surgeons when they evaluate the mechanical performance of the necrotic femoral head.

Exoskeleton-assisted walking rehabilitation for spinal cord injury:CiteSpace analysis of research hotspots / 中国组织工程研究

BACKGROUND:Spinal cord injury is a serious hazard.Walking dysfunction affects the patients'quality of life most.Researches on assisted-walking with exoskeleton robots on patients with spinal cord injury have become increasingly active. OBJECTIVE:To map scientific researches of exoskeleton-assisted walking after spinal cord injury using the CiteSpace software,and to discuss the state of art,cutting-edges in the past 10 years,and trends of research in this field,in hope of providing insights for future investigations and clinical applications. METHODS:Using the Web of Science core database to conduct subject term search by Boolean logical operators,the language English was selected,search strategy:TS="spinal cord injury OR SCI"AND"walk OR walking"AND"robot OR exoskeleton OR(exoskeleton-assisted walking)OR EAW".The knowledge graph software CiteSpace 6.2.R4 was used to de-emphasize the high-quality literature.The high-quality literature obtained after reweighting was subjected to visualization analysis of hotspots and international frontier trends,such as the number of publications,country/research institution cooperation,high-influence authors/literature co-citation,keyword co-occurrence/clustering/emergence,and the scientific knowledge graph was mapped. RESULTS AND CONCLUSION:(1)A total of 544 high-quality articles were included,and the number of articles and total citation frequency in this field have shown an increasing trend in the past 10 years.(2)The top 3 countries in terms of number of publications are the USA,China,and Italy,and the top 3 research institutions are the U.S.Department of Veterans Affairs,the U.S.Veterans Health Administration,and the Swiss Federal Institute of Technology Domian.(3)The authors with the highest citation frequency(167)and betweenness centrality(0.13)are Professor Esquenazi A,University of Pennsylvania,USA,showing a high influence in this field.(4)The analysis of the top 5 cited documents in terms of citation frequency and betweenness centrality shows that:the current research on walking rehabilitation for spinal cord injury patients equipped with powered exoskeleton devices focuses on the judgment of the safety of walking rehabilitation training in real-life environments such as institutions and homes,analysis of the advantages and disadvantages of walking rehabilitation training,design of individualized training programs,and the advantages and disadvantages of the application of powered exoskeleton devices in assisted walking for patients with complete loss of locomotor function in thoracic vertebrae and the segments below,the factors affecting the effectiveness of assisted walking,and the potential for application.(5)In recent years,research in this field has focused on individuals,gait,powered exoskeleton,body weight support,functional electrical stimulation,rehabilitation,assistive technology,ambulation,recovery,and so on.(6)Early research in this field was mostly applied to stroke patients,and the frontier includes weight loss support,reciprocating gait orthosis,functional electrical stimulation and other technical means.Spinal cord injury exoskeleton-assisted walking rehabilitation research has shown an upward trend in recent years,and the focus of attention to the development of adaptive control as the mechanism of the medical lower extremity exoskeleton equipment,safety enhancement,the application of the potential to tap into the cutting-edge direction of the change,the research and detection means on the joint function of the near-infrared spectroscopic imaging and other high-end technologies,focusing on the quality of life of the patient to enhance the ability of athletic training,and to improve the body's structure of the field of the future hotspots and the frontier of the research.

Relationship between muscle activation characterization and fall risk in older adults during walking up and down stairs / 中国组织工程研究

BACKGROUND:During stair walking,different muscles work in concert and compensate for each other,and it is unclear whether weakened muscle strength actually affects stair fall risk in older adults.Real-time electromyographic signals from older adults during stair walking are used to reflect high fall risk in older adults during stair walking,which may further improve the accuracy of prediction methods. OBJECTIVE:To investigate the effects of aging on lower limb muscle activation in older adults during stair walking and to analyze the relationship between their muscle activation characteristics and stair fall risk. METHODS:Subjects were divided by age into an older group(n=19)and a younger group(n=18)group and were asked to walk on a 10-step staircase at a natural speed,incorporating surface electromyography acquisition technology,to capture surface electromyography signals during stair walking and calculate the root mean square(RMS)to analyze differences in muscle activation levels.Logistic regression analysis was utilized to establish a predictive model for stair fall risk in older adults by incorporating the lateral femoral and gastrocnemius muscle RMS.The discrimination of the model was evaluated by the receiver operating characteristic curve and area under the curve,and the fit of the model was evaluated using the Hosmer-Lemeshow test RESULTS AND CONCLUSION:Activation of the rectus femoris(Z=-3.464,P=0.001;t=3.379,P=0.002)and lateral gastrocnemius muscle(Z=-2.978,P=0.003;Z=-3.555,P<0.001)was higher in older adults than in younger adults when walking up and down stairs.Activation of the anterior tibialis(Z=-2.350,P=0.019)and medial(Z=2.321,P=0.020)and lateral(t=3.158,P=0.004)gastrocnemius muscles was higher in older adults when ascending stairs than descending stairs.Older adults at risk for falls had less activation of the lateral femoral muscle(Z=-2.613,P=0.009),medial gastrocnemius muscle(Z=-2.286,P=0.022)when walking upstairs,and lateral femoral muscle(Z=-2.368,P=0.018)when walking downstairs than did older adults not at risk for falls.The predictive ability,goodness of fit,and discrimination of the stair fall prediction model for older adults based on surface electromyography were good(P-value of 0.010 for the Omnibus test of the model coefficients,P-value of 0.214 for the Hosmer-Lemeshow test,and the area of the curve of the upper staircase lateral femoral muscle=0.856,P=0.009).(5)The model was modeled with a cut-off value of 38.64 for the upper staircase lateral femoral muscle RMS value and there was a 0.952-fold increase in the risk of staircase falls for each unit decrease in the upper staircase lateral femoral muscle RMS in older adults.

Spatio-temporal gait characteristics of the elderly and the risk of adverse health outcomes / 中国组织工程研究

BACKGROUND:Gait is one of the optimal indicators of functional status in older adults.Gait parameters are associated with adverse health outcomes in older adults. OBJECTIVE:To summarize and compare the practical value of gait parameters,and to review the progress of research on spatio-temporal parameters and the risk of adverse health outcomes in older adults. METHODS:PubMed,Web of Science,and CNKI were searched for relevant literature published from January 2010 to June 2023 using the search terms of"gait speed,walking speed,step length,cadence,step frequency,step time,walking base,aged and elderly"in English and Chinese,respectively.A total of 52 papers were finally included for the systematic review. RESULTS AND CONCLUSION:Currently,researchers have focused on three basic temporal-spatial parameters,namely,step speed,step length and step frequency,to explore their association with adverse health outcomes in older adults.Reduced gait speed in older adults may increase the risk of falls,all-cause mortality,and may be an independent predictor of all-cause mortality.Older adults with slow gait speed are at higher risk of cognitive decline,and may be the preferred gait parameter in assessing cognitive impairment in older adults.Older adults with slow gait speed are more likely to have debilitating or common chronic illnesses,and are at higher risk of hospitalization and public care.Step length is positively correlated with individual height and lower limb length,but age-induced shortening of step length is not related to height or lower limb length,and shortening of step length reflects reduced physical function in older adults,and shortening of step length is a risk factor for falls and cognitive decline in older adults.Stride frequency is often used as a measure of exercise intensity,and a stride frequency of≥100 steps/minute is predictive of all-cause mortality,and slowing of step frequency may lead to a higher risk of falls,hospitalization and all-cause mortality in older adults.Changes in gait parameters are closely related to the level of physical fitness in older adults,and there may be a bidirectional relationship between the two.The results of the study will provide a theoretical basis for further improving risk screening in clinical populations,refining health risk assessment in the elderly,improving health protection and promoting active health in the elderly.

Propulsion deficits in hemiplegic gait of stroke patients / 中国组织工程研究

BACKGROUND:The abnormal gait of stroke patients seriously affects their propulsive force during walking,which subsequently reduces their walking speed,walking distance,and stability,increases their risk of falls,and seriously affects their quality of life. OBJECTIVE:To review the relevant research on propulsive force deficits in stroke patients with hemiplegia,to summarize the understanding of existing researchers on propulsive force deficits,to analyze the relationship between propulsive force and gait,and finally to explain and compare the latest rehabilitation technologies used to improve propulsive force deficits,providing reference for clinical treatment. METHODS:Relevant literature was retrieved from WanFang,CNKI,PubMed,and Web of Science Core Collection through computer search.The Chinese and English search terms were"propulsive force OR propulsive,stroke OR cerebral infarction OR hemiplegia,walk* OR gait."The search time limit was from 2003 to 2023,and 71 articles were finally included for review and analysis. RESULTS AND CONCLUSION:Training targeting the hip and ankle joints may be more effective for patients'walking function,especially training with the application of flexible exoskeleton robots,but more sufficient evidence is still needed to use propulsion as a prognostic indicator of walking function in stroke patients.Biomechanical variables related to propulsive force include:the hip joint extension angle at terminal stance,ankle joint dorsiflexion torque,and knee joint extension.Damage to the corticospinal tract,cerebellar-cortical pathways,and the reticulospinal tract in hemiplegic patients are associated with reduced propulsive force and gait asymmetry.Propulsive force is crucial for the stability of healthy gait,and a decrease in propulsive force is unfavorable for gait stability.Gait symmetry is correlated with propulsive force,stride length symmetry,trunk displacement,and lower limb swing ability,with propulsive force being a key factor.Propulsive force can serve as a quantitative indicator for assessing the gait of hemiplegic patients,and evaluation of gait using propulsive force is beneficial for the long-term development of walking ability.Main rehabilitation techniques for improving propulsive force include:lower limb exoskeleton robot walking training,treadmill training combined with functional electrical stimulation,adaptive speed treadmill training,biofeedback technology,and whole-body vibration training.Among them,whole-body vibration training and biofeedback technology are more effective.The specific contributions and mechanisms of the hip,knee,and ankle joints in improving propulsive force are still controversial,but it is expected that the contributions of the hip and ankle joints are greater.Focusing on the improvement of propulsive force as a rehabilitation goal may yield more sustainable advancements in walking function.However,several current challenges persist in this field:understanding the neurobiological basis of propulsive force deficits in stroke patients,assessing the long-term efficacy of current rehabilitation techniques for enhancing propulsive force,and determining the most suitable patient populations for the application of major rehabilitation techniques aiming at improving propulsive force.These areas require further exploration by subsequent researchers.

Improving the lower limb functioning and walking ability of stroke survivors with robot-assisted dual-task training / 中华物理医学与康复杂志

Objective:To explore the effects of dual task training assisted by a lower limb rehabilitation robot on lower extremity mobility and the walking ability of stroke survivors.Methods:Sixty-one stroke survivors were randomly divided into a control group and an experimental group with 30 in the control group and 31 in the experimental group. In addition to routine exercise training and physical therapy, both groups were given cognitive-motor dual task training 5 times a week for 3 weeks. But only in the experimental group was the dual task training assisted by a lower limb rehabilitation robot. Both groups′ lower limb motor function, walking ability, cognition, balance and ability in the activities of daily living were evaluated before and after the experiment using the Fugl-Meyer lower extremity assessment (FMA-LE), functional ambulation categories (FAC), the digital span test (DST), the Berg Balance Scale (BBS) and the Modified Barthel Index (MBI). Additionally, 6 survivors of a right hemisphere stroke from the experimental group received cognitive-motor dual task training both with and without the robotic assistance alternately. Near-infrared functional brain imaging was applied before and after the intervention, and the functional network connectivity of the resting brains was analyzed.Results:After the intervention the average FMA-LE, FAC, BBS and MBI scores had improved in both groups, with the improvement in the experimental group significantly better than in the control group on average. In terms of cognition there was no significant difference in the DST forward and backward assessment results between the two groups. The analysis of brain network functional connectivity showed that the intensity of functional connectivity between the left prefrontal cortex (PFC) and the left premotor cortex and supplementary motor cortex (PMC/SMA) increased significantly more, on average, after training assisted by the robot.Conclusion:Dual task training with the assistance of a lower limb rehabilitation robot can effectively improve the lower limb motor function, walking, balance and ability in the activities of daily living of stroke survivors. Enhanced functional connection of the PFC and the PMC/SMA in the healthy hemisphere induced by the robot may be the cause.

Sustained Effects of Underwater Walking on Respiratory Muscle Strength of the Elderly / 日本温泉気候物理医学会雑誌

  Purpose: This study aimed to investigate the effects of underwater walking for 6 weeks at 60% of the predicted maximum heart rate on respiratory muscle strength of elderly people as well as its sustained effects on respiratory muscle strength.  Methods: The participants were 43 healthy elderly men, who were randomly divided into the continuous group (n=21) and the non-continuous group (n=22). Initially, both groups performed 30 min of underwater walking four times a week for 6 weeks, after which the continuous group continued the same for another 6 weeks, whereas the non-continuous group was prohibited from performing any exercise, except for daily activities. The walking speed during underwater walking was adjusted such that the exercise intensity was 60% of the predicted maximum heart rate, with the water depth up to the fourth intercostal space or higher.   Outcome Measures: The maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and vital capacity (VC) were measured before exercise and 6, 8, 10, and 12 weeks after exercise.   Results: The PImax and PEmax were significantly higher after 6 weeks of exercise than those before exercise. In the continuation group, PEmax increased significantly at 12 weeks of exercise compared to that at 6 weeks, whereas PImax did not show a significant increase. In the non-continuous group, PEmax decreased significantly from the 10th week onwards as compared to that at 6 weeks and showed a significantly lower value than that of the continuous group. The PImax of the non-continuous group decreased significantly at 12 weeks compared to that at 6 weeks. The VC after the 6-week underwater walking program did not differ from the pre-exercise value, with no significant difference observed between the two groups. Moreover, the VC in both groups showed no significant changes after 12 weeks of underwater walking compared to that after 6 weeks.  Conclusions: Because underwater walking involves moving forward while resisting water pressure, it is necessary to activate the expiratory abdominal muscles to stabilize the trunk. Notably, the respiratory muscle strength in the non-continuous group decreased 4-6 weeks after the underwater walking program was terminated.

Assessing Correlations among Repetitive Standing Test on a Dining Room Seat, Daily Walking, Balance Function, and Walking Endurance in Geriatric Health Services Facility Residents / The Japanese Journal of Rehabilitation Medicine

Objective：To evaluate the relationship among repetitive standing tests in a dining room seat, daily walking, balance function, and walking endurance in geriatric health service facility residents.Methods： Eighty-six geriatric health service facility residents. Participants were categorised into wheelchair, assistance, modified independence, and independent groups based on walking in the functional independence measure. The repetitive standing test in a dining room seat was compared. Cut-off values were determined based on differences between consecutive groups. Correlations among the repetitive standing test on a dining room seat, Berg balance scale score, and 6-minute walk distance were determined.Results：The repetitive standing test on a dining room seat was higher in the assistance group than in the wheelchair group and higher in the modified independence group than in the assistance group, with cut-off values of 5 and 20 times, respectively. The repetitive standing test on a dining room seat was positively correlated with the Berg balance scale and 6-minute walk distance.Conclusion：The repetitive standing test on a dining room seat was correlated with balance function and walking endurance. Five and twenty repetitions of the standing test on a dining room seat were needed for assisted and modified independent walking, respectively.

Development, Reliability and Validity of Scales for Assessment of Walking Level in Convalescent Rehabilitation Ward / The Japanese Journal of Rehabilitation Medicine

Objective：To evaluate the reliability and concurrent validity of the Walking LEVEL Scale (WaLS) in patients hospitalized in a Convalescent Rehabilitation Ward (CRW).Design：The WaLS was used as an assessment scale to categorize the walking ability of patients in a CRW.Subjects/Patients：A total of 103 patients in a CRW were included in the study.Methods：Retest and inter-rater reliability were evaluated by using the WaLS to assess patients by the same rater and by two independent raters using the weighted kappa coefficient. Spearman correlation was used to assess the correlation between the WaLS and FIM-walk item scores and the WaLS and FAC scores (i.e., concurrent validity).Results：The retest and inter-rater reliability of the WaLS (weighted kappa coefficient) was 0.989 (p＜0.01) and 0.951 (p＜0.01), respectively. The WaLS scores were also significantly correlated with the FIM-walk item (p＝0.916, p＜0.01) and FAC scores (p＝0.919, p＜0.01)．Conclusion：The WaLS was found to demonstrate good reliability and concurrent validity in patients hospitalized in CRW.

The effect of a visual walking training based on wearable walking guide devices on the walking ability of Parkinson's disease patients with freezing of gait / 中国康复医学杂志

Objective:To investigate the effect of a visual walking training based on wearable cueing devices on ground reaction force of Parkinson's disease patients with freezing of gait. Method:Twenty-three PD with FOG(PD+FOG)were selected and twenty healthy controls(HC)were tested in gait laboratory.The experimental group was trained with wearable walking guide devices for 20 minutes,twice a day for one week.The Vicon 3D gait analysis system was used to collect the spatiotemporal parame-ters and the ground reaction force parameters of the non-dominant side and the dominant side including front-back peak,medial-lateral peak and the first vertical peak)of the experimental group and the control group be-fore and after training. Result:①After the intervention,the bilateral step length and velocity of patients in the experimental group in-creased signi ficantly(P＜0.05),while cadence,double stance phase decreased significantly(P＜0.05).After train-ing,there was no significant difference in the dominant step length,cadence and double stance phase between experimental group and control group(P＞0.05).②After the training,bilateral parameters(landing angles of hip joints,the maximum angles of ankle dorsiflexion and plantar flexion,and the ranges of motion of lower limb joints)in the experimental group increased significantly,while the landing angles of knee joints de-creased,and the stage of the first peak of ankle joints was delayed,with statistical significance(P＜0.05).Af-ter the training,knee joint landing angle,maximum ankle dorsiflexion angle,the first peak stage of ankle joint,lower limb joint range of motion had no significant difference between the experimental group and the control group in both sides(P＞0.05).③After the intervention,the front-back peak value and the first vertical peak of the bilateral ground reaction force in the experimental group were significantly increased(P＜0.05),while the medial-lateral peak value of the ground reaction force was significantly decreased(P＜0.05).Compared with the control group,there was no significant difference in the backward peak,medial peak of non-domi-nant side and parameters of the dominant side(P＞0.05). Conclusion:The visual walking training based on wearable walking guide devices improve the stability and consistency of gait of PD+FOG.

Effects of whole-body vibration combined with squat-up synchronization training on walking function of stroke patients based on superposition effect / 中国康复医学杂志

Objective:To explore the synchronization effect of whole-body vibration therapy combined with squat-up train-ing on ambulation of patients with stroke. Method:40 stroke survivors who could walk independently with supervision or assistive devices,were recruit-ed from the Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University(Pudong Cam-pus)and were randomly divided into the WBVT group and the control group.Both groups received conven-tional rehabilitation treatment for 40 minutes per day.The WBVT group was given additional whole-body vibra-tion therapy while squat-up training for another 20 minutes a day.The control group added sham stimulation of standing on the vibration platform with no vibration for the same amount of time per day.At the begin-ning of enrollment and after 4 weeks intervention,participants received two times evaluation by the wearable three-dimensional gait assessment instrument for the function of walking,and the electromyographic signals of the rectus femoris and long head of the biceps femoris were collected by surface electromyography instrument and statistical analysis on the data before and after the intervention. Result:After 4 weeks intervention,the stride speed and stride length of both groups improved siginificanlty(P＜0.05),while the WBVT group was better than the control group(P＜0.05).The swing angle of knee(flex-ion or extention)in the WBVT group improved significantly after intervention compared with the control group.At the single leg support phase(SS)of affected side,the differences were found in the synergistic contraction rate of the rectus femoris and biceps femoris in the bilateral lower extremity of the WBVT group after the in-tervention(P＜0.05).At the swing phase(SW)of affected side,the differences were found in the synergistic contraction rate of the rectus femoris and biceps femoris in the bilateral lower extremity between the two groups before and after the intervention(P＜0.05),but the affected side of the WBVT group was better than that the control group after intervention(P＜0.05). Conclusion:Whole-body vibration therapy combined with rhythmic squat-up synchronous training can improve the stride speed,stride length and synergistic contraction rate of lower limb muscles for better ambulation of patients with stroke.

Effect of enriched environment theory-based multisensory feedback gait training on walking function in stroke patients / 中国康复理论与实践

ObjectiveTo explore the effect of multi-sensory artificial intelligence feedback gait training on the recovery of walking function in stroke patients based on enriched environment theory. MethodsFrom July, 2021 to June, 2023, a total of 80 stroke patients in Huashan Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation in the lying and seated positions, for 40 minutes. The control group received ground walking training, for 20 minutes, while the experimental group received multi-sensory feedback gait training in enriched environment, for 20 minutes. Before and after four weeks intervention, the digital motion monitoring treadmill was used to mearsure step speed, step length, hip and knee swing angle and weight symmetry. They were assessed with Berg Balance scale (BBS), Fugl-Meyer Assessment-Lower Extremities (FMA-LE) and Barthel Index (BI). ResultsAfter intervention, the hip swing angle, step length of both sides and step speed significantly improved in both groups (|t| > 3.162, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.568, P < 0.05); the average knee joint swing angle and bilateral weight-bearing symmetry significantly improved in the experimental group (|t| > 3.249, P < 0.01); the scores of BBS, FMA-LE and BI improved in both groups (|t| > 3.569, P < 0.01), and they were better in the experimental group than in the control group (|t| > 2.922, P < 0.05). ConclusionMulti-sensory feedback gait training based on enriched environment theory could effectively improve the walking and balance of stroke patients, and increase the ability of independence.