Study on the Characteristics of Plantar Pressure in Stroke Patients and its Correlation with Trunk, Balance and Motor Function
GUO Shuai, ZHANG Yumei, ZHAO Yishuang, LIU Lipeng, GONG Weijun, WANG Shurong
2023, 18(8):
879-884.
DOI: 10.3969/j.issn.1673-5765.2023.08.005
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Objective To explore the characteristics of plantar pressure in stroke patients and its correlation with trunk, balance, and motor function.
Methods The study prospectively included stroke patients admitted to the Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University from June 2021 to November 2022. Upon admission, trunk function was assessed by the trunk impairment scale (TIS), balance function was assessed by the Berg balance scale (BBS), and lower extremity motor function was assessed by the Fugl-Meyer assessment lower extremity (FMA-LE) . Plantar pressure assessment was performed on both lower limbs in the eyes open and eyes closed states, and the plantar pressure characteristics of the unaffected and affected limbs were compared [weight-bearing, enveloping ellipse area, center of pressure (COP) path length, and COP mean velocity]. Correlation analysis was performed to assess the relationship between TIS, BBS, FMA-LE, and plantar pressure indices in the eyes open state of both lower limbs.
Results A total of 45 stroke patients were included, with 35 males (77.8%). When comparing the plantar pressure characteristics between the unaffected and affected sides, the overall weight-bearing of the unaffected lower limb was higher than that of the affected lower limb in both open-eyed (58.6%±11.1% vs. 41.4%±11.1%, P<0.001) and closed-eyed (59.0%±11.8% vs. 40.9%±11.8%, P<0.001) states. The comparison of plantar pressure characteristics between open-eyed and closed-eyed states showed that the envelope ellipse area [(408.1±172.1) mm2 vs. (241.9±143.1) mm2, P<0.001] was larger than that in open-eyed state, the COP path length [(227.8±110.4) mm vs. (130.7±62.4) mm, P<0.001] was longer than that in open-eyed state, and the COP average velocity [(23.5±11.3) mm/s vs. (13.7±6.4) mm/s,
P<0.001] was higher than that in open-eyed state. In the open-eyed state, the weight-bearing of the forefoot of the unaffected side (41.7%±12.8% vs. 38.2%±12.0%, P=0.015) and affected side (39.0%±12.5% vs. 36.5%±12.1%, P=0.020) was higher than that in the closed-eyed state, while the weight-bearing of the hindfoot of the unaffected side (58.3%±12.8% vs. 61.7%±12.1%, P=0.015) and affected side (60.7%±12.8% vs. 63.4%±12.1%, P=0.018) was lower than that in the closed-eyed state. These differences were all statistically significant. Correlation analysis showed that TIS, BBS, and FMA-LE were negatively correlated with the envelope ellipse area in open eyes state
(r=-0.472, P=0.001; r=-0.537, P<0.001; r=-0.485, P=0.001), COP path length (r=-0.427, P=0.003; r=-0.561, P<0.001; r=-0.424, P=0.004), COP average velocity (r=-0.436, P=0.003; r=-0.563, P<0.001; r=-0.425, P=0.004), and overall weight-bearing of the unaffected lower limb (r=-0.326, P=0.029; r=-0.446, P=0.002; r=-0.551, P<0.001), but positively correlated with the overall weight-bearing of the affected lower limb (r=0.326, P=0.029; r=0.446, P=0.002; r=0.551, P<0.001).
Conclusions Stroke patients showed a weight-bearing asymmetry towards the unaffected side. In the absence of visual input, their static standing balance was compromised. TIS, BBS, and FMA-LE were negatively correlated with the extent of body sway and overall weight-bearing on the unaffected side during quiet standing, while positively correlated with overall weight-bearing on the affected side.
