Relationship between dynamic stability control and risk of falling and physical activity during uneven terrain walking in patients with hemiparesis

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K19407
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Kumamoto Health Science University (2021-2022); Tohoku University (2020)
• Principal Investigator: Honda Keita 熊本保健科学大学, 保健科学部, 講師 (30823314)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 脳卒中片麻痺患者 / 歩行 / 転倒 / 身体活動量 / 全身角運動量 / Margin of stability / バイオメカニクス / 3次元動作解析

Outline of Final Research Achievements

We investigated the characteristics of gait on uneven terrain for patients with hemiparesis who have high risk of falling. Study 1) revealed that during gait on grass surfaces, patients with a history of falls showed higher toe clearance caused by increasing the angular velocity of posterior pelvic tilt at paretic toe-off. Study 2) showed that older healthy subjects had greater dynamic stability in the anterior-posterior direction during gait on soft surfaces, which was attributed to an increase in thoracic flexion angle and ankle plantar flexion angle at initial contact. Study 3) showed that patients with hemiparesis did not increase dynamic stability in the anterior-posterior direction during gait on soft surfaces, whereas healthy subjects did. In addition, we showed that the lower limb joint kinematics during gait on the soft surface were different between healthy subjects and patients with hemiparesis.

Free Research Field

リハビリテーション

Academic Significance and Societal Importance of the Research Achievements

本課題は、高い転倒リスクが問題となる脳卒中片麻痺患者の不整地歩行時の動的安定性について調べた初の試みである。本課題では、転倒の主な原因である躓きとバランス損失の視点から芝生及び柔らかい路面の歩行時の特徴を調べた。芝丈が30 mmの路面では転倒リスクが高い脳卒中患者の骨盤に特徴的な動きがあることや身体動揺を誘発するような柔らかい路面では脳卒中患者が適切に前後方向の動的安定性を制御できないことを明らかにした。これらのことは転倒を予防しながら、屋外活動の範囲を拡大していくために、脳卒中患者の歩行リハビリテーションにおいて注目すべき点を整理することに繋がった。