van Uden C J T, van der Vleuten C J M, Kooloos J G M, Haenen J H, Wollersheim H
Department of Physical Therapy, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Clin Rehabil. 2005 May;19(3):339-44. doi: 10.1191/0269215505cr809oa.
To gain insight in gait and calf muscle endurance in patients with severe chronic venous insufficiency.
Fifteen patients with severe chronic venous insufficiency (healed or active ulcers) and 19 healthy controls were selected for this study. Subjects had to perform eight trials at preferred walking speed and eight trials at instructed walking speed (1.25 m/s) during which the gait parameters were recorded. The calf muscle endurance was tested by use of the heel-rise test.
Patients had a significantly lower preferred walking speed (1.25 m/s +/- 0.31) compared with healthy controls (1.44 m/s +/- 0.0.15) (p = 0.039). During preferred walking speed patients had a wider base of support (p = 0.003), a bigger step time (p = 0.005), and a bigger stride time (p = 0.004) compared with healthy controls. At instructed walking speed only base of support was different between the two groups (p = 0.016). Patients had a significantly (p = 0.003) smaller number of heel rises (14.6 +/- 7.34), indicating decreased calf muscle endurance compared with controls (23.5 +/- 6.54).
This study indicates a disturbed gait and decreased calf muscle endurance in patients with severe chronic venous insufficiency. The results of this study point to a possible role for gait and strength training in the rehabilitation process of patients with severe chronic venous insufficiency.
深入了解重度慢性静脉功能不全患者的步态及小腿肌肉耐力。
本研究选取了15例重度慢性静脉功能不全患者(溃疡已愈合或仍处于活动期)和19名健康对照者。受试者需以偏好步行速度进行8次试验,并以规定步行速度(1.25米/秒)进行8次试验,在此期间记录步态参数。通过足跟抬起试验测试小腿肌肉耐力。
与健康对照者(1.44米/秒±0.15)相比,患者的偏好步行速度显著更低(1.25米/秒±0.31)(p = 0.039)。在偏好步行速度时,与健康对照者相比,患者的支撑面更宽(p = 0.003)、步长时间更长(p = 0.005)、步幅时间更长(p = 0.004)。在规定步行速度时,两组之间仅支撑面存在差异(p = 0.016)。与对照组(23.5±6.54)相比,患者的足跟抬起次数显著更少(14.6±7.34)(p = 0.003),表明小腿肌肉耐力下降。
本研究表明重度慢性静脉功能不全患者存在步态紊乱及小腿肌肉耐力下降。本研究结果指出步态和力量训练在重度慢性静脉功能不全患者康复过程中可能发挥的作用。