目的：通过与健康成人对比，探讨脑卒中患者步行中肩峰-骨盆角度的运动学特征，并从生物力学角 度分析这一运动学特征变化的原因。方法：选取2023年8月～12月我院收治的脑卒中患者45例（卒中组）， 招募9位健康成人受试者（对照组）。通过使用三维步态分析，比较2组受试者的步速、支撑相时间、支撑相 肩峰-骨盆角度最大值和最小值、步态周期肩峰-骨盆角度最大值和最小值等主要结局指标是否具有统计学 差异，并分析其生物力学基础。结果：2组受试者肩峰-骨盆角度最大值和最小值与下肢生物力学参数的相 关性分析结果显示：脑卒中患者步行支撑相肩峰-骨盆角度最大值与足偏角最大值成正相关，与胸廓旋转角 度最小值、踝关节背屈-跖屈角度最小值以及踝关节矢状轴力矩最小值存在负相关。脑卒中患者整个步态 周期肩峰-骨盆角度最大值与髋关节屈伸力矩最大值、髋关节屈伸做功最大值、足偏角最大值成正相关；与 髋关节屈伸角度最小值、踝关节背屈-跖屈角度最小值以及踝关节矢状轴力矩最小值成负相关（均P＜0.05， 且相关系数ρ＞0.5）。与健康成人相比，脑卒中患者在步行中的支撑相肩峰-骨盆最大值、步态周期肩峰-骨 盆最大值及步速均显著下降，差异均有统计学意义（均P＜0.01）。结论：脑卒中患者步行中肩峰-骨盆角度 变化与健康人群相比运动幅度下降，以同相运动模式为主。从生物力学角度理解，下肢运动学和动力学的 耦合关系发生变化，以髋策略调控为主。

To investigate the kinematic characteristics of acromion-pelvic angle during walking in stroke patients by comparing them with healthy subjects, and to analyze the reasons underneath from biomachanic perspective. Methods: A total of 45 stroke subjects (stroke group) and 9 healthy subjects (control group) were recruited from the Department of Rehabilitation Medicine, West China Hospital, Sichuan University. 3D gait analysis was used to compare whether there were statistical differences between two groups in the main outcome indicators such as gait speed, stance time, peak acromion-pelvic angle during stance phase, and peak acromion-pelvic angle during whole gait cycle. In addition, the reasons for the statistical difference between the two groups were analyzed from the biomechanical perspective. Results: Compared with healthy adults, there were statistically significant differences in peak acromion-pelvic angle during stance phase, peak acromion-pelvic angle during whole gait cycle, and gait speed (all P<0.01). This study also found that the maximum value of acromion-pelvic angle during stance phase in stroke patients was positively correlated with peak foot angle, and negatively correlated with minimum thorax rotation angle, minimum ankle dorsiflexion-plantar flexion angle, and minimum value of ankle moment. The maximum acromion-pelvic angle was positively correlated with peak hip saggital moment, hip saggital power, and foot angle, and negatively correlated with minimum hip flexion and extension angle, minimum ankle dorsiflexion-plantar flexion angle, and minimum ankle sagittal moment in stroke patients (all P<0.05 and ρ>0.5). Conclusion: In this study, it was found that the change of acromion-pelvic angle during walking in stroke patients decreased compared with that of healthy people, and the movement pattern was mainly in phase. From the perspective of biomechanics, the coupling relationship between kinematics and dynamics of lower limbs is understood, and hip strategy is the main focus.