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40岁以上健康成年人爬楼梯任务的额状面和矢状面分析:与平地行走相比有哪些挑战?

Frontal and sagittal plane analyses of the stair climbing task in healthy adults aged over 40 years: what are the challenges compared to level walking?

作者信息

Nadeau S, McFadyen B J, Malouin F

机构信息

Centre de recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal métropolitain, site Institut de réadaptation de Montréal, (Qc), Canada H3S 2J4.

出版信息

Clin Biomech (Bristol). 2003 Dec;18(10):950-9. doi: 10.1016/s0268-0033(03)00179-7.

Abstract

OBJECTIVE

This study compared stair climbing and level walking in healthy adults aged over 40 years.

DESIGN

Eleven subjects performed at their comfortable speed.

BACKGROUND

The number of parameters studied during stair climbing has been limited, in particular in the frontal plane.

METHODS

Time-distance parameters and three-dimensional kinematic data were obtained using foot-switches and an Optotrak system. Ground reaction forces were collected with a force platform embedded in the second step of the staircase or in the ground for level walking. Relative angles were calculated using a Cardanic rotation matrix and the net moments and the powers at the ankle, knee and hip joints were estimated with an inverse dynamic approach.

RESULTS

A significant longer mean cycle duration and a shorter proportion of time in stance was obtained for stair climbing as compared to level walking. Profiles of the frontal plane joint angles, moments and powers indicated a different action of the hip abductors across tasks to control the pelvis in stance. Profiles of the sagittal plane confirmed the dominant role of the knee extensors during stair climbing but revealed also a knee-hip energy generation pattern that allows the avoidance of the intermediate step.

CONCLUSIONS

Results suggest environment specific adaptations of the neuro-musculo-skeletal system that should be considered in the rehabilitation of stair climbing in patients.

RELEVANCE

This study highlights the challenges of stair climbing compared to level walking in a within subject design. Key features of stair climbing that are important for the rehabilitation of step management are also reported.

摘要

目的

本研究比较了40岁以上健康成年人爬楼梯和平地行走的情况。

设计

11名受试者以舒适的速度进行测试。

背景

爬楼梯过程中所研究的参数数量有限,尤其是在额状面。

方法

使用脚踏开关和Optotrak系统获取时间-距离参数和三维运动学数据。通过嵌入楼梯第二步或地面的测力平台收集平地行走时的地面反作用力。使用卡丹旋转矩阵计算相对角度,并采用逆动力学方法估计踝关节、膝关节和髋关节的净力矩和功率。

结果

与平地行走相比,爬楼梯的平均周期持续时间明显更长,站立时间比例更短。额状面关节角度、力矩和功率的曲线表明,在不同任务中,髋外展肌在站立时控制骨盆的作用不同。矢状面曲线证实了爬楼梯时膝关节伸肌的主导作用,但也揭示了一种膝-髋能量产生模式,可避免中间步骤。

结论

结果表明神经肌肉骨骼系统会根据环境进行特定适应,这在患者爬楼梯康复中应予以考虑。

相关性

本研究突出了在受试者内设计中爬楼梯与平地行走相比所面临的挑战。还报告了对步幅管理康复很重要的爬楼梯关键特征。

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