Abstract

This study aimed to assess the effect of the Lower Extremity Constraint-Induced Movement Therapy (LE-CIMT) intervention on the intra-limb hip-knee coordination and its variability in walking in chronic post-stroke individuals considering the lenses of the dynamic systems approach to motor behavior. Twelve chronic post-stroke individuals received the LE-CIMT intervention for 10 days following all protocol’s recommendations and designed according to individuals’ needs. Before, three days, and 30 days after the intervention, angular kinematics in the sagittal plane of the trunk, hip and knee of both extremities were analyzed. We analyzed joint angles for swing and stance phases of walking, and the intra-limb coordination of hip-knee joints through the vector coding technique. For separate joint angular kinematics, we found differences between affected extremities but no effects of the intervention. However, we observed changes in intra-limb coordination pattern as a function of increased variability after intervention and increased stability at follow-up. These changes follow the predicted pattern from the dynamic systems approach to motor behavior. The immediate decreased stability of the initial pattern could be due to the active exploration of space solution offered by the LE-CIMT and, posteriorly, the stability increased after finding new movement solutions in the real-life environment.

摘要

本研究旨在评估下肢约束诱导运动疗法 (LE-CIMT) 干预对肢体内髋膝关节协调性及其在慢性中风后个体行走中的变异性的影响，考虑到动态系统方法的镜头运动行为。12 名慢性卒中后患者按照所有方案的建议接受 LE-CIMT 干预 10 天，并根据个人需求进行设计。分析干预前、干预后3天、干预后30天的躯干、髋、膝矢状面角运动学特征。我们通过矢量编码技术分析了行走的摆动和站立阶段的关节角度，以及髋膝关节的肢体内协调。对于单独的关节角运动学，我们发现受影响的四肢之间存在差异，但干预没有效果。然而，我们观察到肢体内协调模式的变化是干预后变异性增加和随访稳定性增加的函数。这些变化遵循从动态系统方法到运动行为的预测模式。初始模式的稳定性立即下降可能是由于 LE-CIMT 提供的空间解决方案的积极探索，以及后来，在现实生活环境中找到新的运动解决方案后稳定性增加。这些变化遵循从动态系统方法到运动行为的预测模式。初始模式的稳定性立即下降可能是由于 LE-CIMT 提供的空间解决方案的积极探索，以及后来，在现实生活环境中找到新的运动解决方案后稳定性增加。这些变化遵循从动态系统方法到运动行为的预测模式。初始模式的稳定性立即下降可能是由于 LE-CIMT 提供的空间解决方案的积极探索，以及后来，在现实生活环境中找到新的运动解决方案后稳定性增加。