The differences in kinetic mechanisms of decreased gait speed across brain lesion sides have not been elucidated, including the arrangement of motor modules reflected by kinetic interjoint coordination. The purpose of this study was to elucidate the differences in the kinetic factors of slow gait speed in patients with stroke on the lesion sides. A three-dimensional motion analysis system was employed to assess joint moment in the lower limb and representative gait parameters in 32 patients with right hemisphere brain damage (RHD) and 38 patients with left hemisphere brain damage (LHD) following stroke as well as 20 healthy controls. Motor module composition and timing were determined using principal component analysis based on the three joint moments in the lower limb in the stance phase, which were the variances accounted for principal components (PCs) and the peak timing in the time series of PCs. A stepwise multiple linear regression analysis was performed to identify the most significant joint moment and PC-associated parameter in explaining gait speed. A negligible difference was observed in age, weight, height, and gait speed among patients with RHD and LHD and controls. The following factors contributed to gait speed: in patients with RHD, larger ankle plantarflexion moment on the paretic (p = 0.001) and nonparetic (p = 0.002) sides and ankle dorsiflexion moment on the nonparetic side (p = 0.004); in patients with LHD, larger ankle plantarflexion moment (p < 0.001) and delayed peak timing of the first PC (p = 0.012) on the paretic side as well as ankle dorsiflexion moment on the nonparetic side (p < 0.001); in the controls, delayed peak timing of the first PC (p = 0.002) on the right side and larger ankle dorsiflexion moment (p = 0.001) as well as larger hip flexion moment on the left side (p = 0.023). The findings suggest that the kinetic mechanisms of gait speed may differ among patients with RHD following patients with stroke with LHD, and controls.

中文翻译：

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影响脑卒中患者病灶侧步态速度的动力学因素差异

大脑病变侧步态速度降低的动力学机制的差异尚未阐明，包括运动关节间协调反映的运动模块的排列。本研究的目的是阐明脑卒中患者病灶侧慢步态动力学因素的差异。采用三维运动分析系统评估 32 名右半球脑损伤 (RHD) 患者和 38 名中风后左半球脑损伤 (LHD) 患者以及 20 名健康人的下肢关节力矩和代表性步态参数。控制。基于站立阶段下肢的三个关节力矩，使用主成分分析确定运动模块的组成和时序，这是主成分（PC）的方差和PC时间序列中的峰值时序。进行逐步多元线性回归分析，以确定在解释步态速度时最重要的关节力矩和 PC 相关参数。 RHD 和 LHD 患者与对照组在年龄、体重、身高和步态速度方面观察到的差异可以忽略不计。以下因素影响步态速度：在 RHD 患者中，麻痹患者的踝关节跖屈力矩较大（p= 0.001) 和无麻痹 (p= 0.002) 非麻痹侧的侧面和踝关节背屈力矩 (p= 0.004); LHD 患者的踝关节跖屈力矩较大（p< 0.001）和第一台 PC 的延迟峰值时序（p= 0.012）在麻痹侧以及非麻痹侧的踝关节背屈力矩（p< 0.001）；在控制中，延迟第一台 PC 的峰值时间（p= 0.002) 右侧踝关节背屈力矩较大 (p= 0.001）以及左侧较大的髋部屈曲力矩（p= 0.023）。研究结果表明，RHD 患者的步态速度动力学机制可能与 LHD 卒中患者和对照患者不同。