目的 对比社区脑卒中患者单任务步行与不同类型和不同负荷双任务步行时步态参数及其对称性的差异。 方法 利用Simi Motion三维动作分析系统采集20名处于慢性恢复期的社区脑卒中患者在单任务步行及不同负荷认知双任务步行和运动双任务步行时步态参数并间接计算出其对称指数。采用单因素重复测量方差分析对比单任务步行与不同双任务步行时步态参数及其对称性差异。 结果 与单任务步行相比,社区脑卒中患者在高低负荷认知任务介入时步速、步幅、患侧步长、健侧摆动相占比均降低(p<0.05),困难认知任务介入时步宽和健侧、患侧支撑相占比增加(p<0.05)、健步长和患侧摆动相占比降低(p<0.05),摆动相占比对称指数减小(p<0.05)。 结论 社区脑卒中患者主要通过降低步速、缩减步幅和步长、降低摆动相占比、增加步宽和支撑相占比,改变步态模式来应对认知任务干扰,对于步态稳定性,高负荷认知任务的介入,会增加社区脑卒中患者摆动相占比的不对称性程度,降低其步态稳定性。
Objective To compare the difference of gait parameters and symmetry between single-task walking and double-task walking with different types and different loads in community stroke patients. Methods The gait parameters of 20 community stroke patients in chronic convalescence were collected by Simi Motion three-dimensional motion analysis system during single-task walking, cognitive double-task walking and motor double-task walking with different loads, and the symmetry index was calculated indirectly. The single-factor repeated measure variance analysis was used to compare the gait parameters and symmetry differences between single-task walking and different double-task walking. Results Compared with single-task walking, the walking speed, stride length, stride length of affected side and the proportion of healthy side swing in community stroke patients during intervention of high-low load cognitive tasks were decreased (p<0.05), while the proportion of stride width and support of healthy side and affected side was increased during intervention of difficult cognitive tasks (p<0.05), and the proportion of robust stride length and affected side swing was decreased (p<0.05). The symmetry index of oscillating phase proportion decreased (p<0.05). Conclusions Community stroke patients mainly deal with cognitive task interference by reducing walking speed, reducing stride length and stride length, reducing swing proportion, increasing step width and support proportion, and changing gait pattern. For gait stability, the intervention of high-load cognitive tasks will increase the asymmetry degree of swing proportion of community stroke patients and reduce their gait stability.