Clark Brian C, Manini Todd M, Ordway Nathaniel R, Ploutz-Snyder Lori L
Musculoskeletal Research Laboratory, Department of Exercise Science, Syracuse University, NY 13244, USA.
Arch Phys Med Rehabil. 2004 Sep;85(9):1555-60. doi: 10.1016/j.apmr.2003.09.011.
To evaluate the muscle activation patterns at varying levels of weight-bearing forces during assisted walking with an axillary crutch and a recently designed device that allows weight transfer through the pelvic girdle (ED Walker).
Descriptive, repeated measures.
University-based research laboratory.
Twelve healthy volunteers (age, 39.6+/-13.6 y).
Not applicable.
Electromyographic activity was recorded from the anterior tibialis, soleus, biceps femoris, and vastus lateralis muscles on a test leg during assisted axillary crutch and ED Walker ambulation. Force platform readings measured weight-bearing load (non, light, heavy). These values were normalized to normal walking gait.
In the vastus lateralis and soleus muscles, both devices allowed for approximately 50% and 65% reductions in electromyographic activity during the non-weight-bearing condition. During crutch ambulation, electromyographic activity of the soleus was significantly reduced compared with that required for normal walking at all levels of weight-bearing load. In the vastus lateralis for the weight-bearing conditions, the ED Walker required significantly higher electromyographic activity than crutch ambulation (light: 105.0%+/-12.3% vs 72.7%+/-10.1%; heavy: 144.8%+/-23.5% vs 100.0%+/-13.5%). Both devices required similar peak vertical ground reaction forces during the heavy weight-bearing conditions (crutch: 75%+/-1.6%; ED Walker: 73%+/-1.8%), whereas axillary crutch gait produced less force than the ED Walker in the light condition (32%+/-2.0% vs 48%+/-1.6%).
During walking with assistive devices, muscle activation patterns varied with weight-bearing load. The leg extensor muscles appeared to incur a greater reduction in muscle activity when compared with their flexor counterparts. Additionally, the ED Walker and axillary crutch differed with respect to their muscle activity levels and weight-bearing characteristics. Clinically, knowledge of these muscle activity and force characteristics may aid in the decision-making process of prescribing a device type and timeline to follow in restoring weight-bearing loads.
评估在使用腋拐辅助行走以及使用最近设计的一种允许通过骨盆带进行体重转移的装置(ED Walker)时,不同负重水平下的肌肉激活模式。
描述性、重复测量研究。
大学研究实验室。
12名健康志愿者(年龄,39.6±13.6岁)。
不适用。
在使用腋拐和ED Walker辅助行走期间,记录测试腿上胫前肌、比目鱼肌、股二头肌和股外侧肌的肌电图活动。测力平台读数测量负重负荷(无、轻、重)。这些值被标准化为正常行走步态。
在股外侧肌和比目鱼肌中,两种装置在非负重状态下均使肌电图活动分别降低约50%和65%。在使用腋拐行走期间,与正常行走在所有负重负荷水平下所需的肌电图活动相比,比目鱼肌的肌电图活动显著降低。在负重状态下的股外侧肌中,ED Walker所需的肌电图活动显著高于腋拐行走(轻:105.0%±12.3%对72.7%±10.1%;重:144.8%±23.5%对100.0%±13.5%)。在重负重状态下,两种装置所需的垂直地面反作用力峰值相似(腋拐:75%±1.6%;ED Walker:73%±1.8%),而在轻负重状态下,腋拐步态产生的力小于ED Walker(32%±2.0%对48%±!6%)。
在使用辅助装置行走时,肌肉激活模式随负重负荷而变化。与屈肌相比,伸肌的肌肉活动似乎减少得更多。此外,ED Walker和腋拐在肌肉活动水平和负重特征方面存在差异。临床上,了解这些肌肉活动和力的特征可能有助于在规定恢复负重负荷的装置类型和时间安排的决策过程中提供帮助。