Radtka Sandra A, Oliveira Gina B, Lindstrom Kristen E, Borders Michael D
Graduate Program in Physical Therapy, San Francisco State University/University of California at San Francisco, 1600 Holloway Avenue, San Francisco, CA 94132, USA.
Gait Posture. 2006 Oct;24(2):211-8. doi: 10.1016/j.gaitpost.2005.09.005. Epub 2005 Nov 2.
This study compared the effects of a unilateral solid ankle-foot orthosis (AFO), hinged AFO and no AFO (shoe) worn by healthy adults on pelvic angles, lower extremity joint angles, moments and powers, and temporal-spatial gait characteristics during stair locomotion. A convenience sample of 19 healthy adults participated in this repeated measures design with subjects serving as their own controls. Subjects ambulated on stairs wearing a left shoe and either a right solid AFO, hinged AFO or shoe. Kinematic and kinetic data were collected with motion analysis equipment and a force plate for the three conditions. Pelvic angles and right hip, knee and ankle angles, moments and powers during stance were compared to determine differences among the conditions. Subjects wearing either orthosis walked slower during stair locomotion and with a shorter right single limb support time during descent. Sagittal knee and ankle angles, moments and powers were similar in individuals wearing a hinged AFO or shoe during pull-up (PU) in ascent and controlled lowering (CL) in descent. Decreased ankle dorsiflexion angle, plantar flexion power, knee flexion angle and extensor moment were seen in subjects wearing a solid AFO as compared to a hinged AFO during PU in ascent and CL in descent. Findings contributed to understanding how biomechanical changes imposed at the ankle by a unilateral solid AFO resulted in more kinetic and kinematic compensations than the hinged AFO in healthy adults without the confounding effects of neuromuscular impairments.
本研究比较了健康成年人佩戴单侧固态踝足矫形器(AFO)、铰链式AFO和不佩戴AFO(仅穿鞋子)时,在上下楼梯过程中对骨盆角度、下肢关节角度、力矩和功率以及时空步态特征的影响。19名健康成年人的便利样本参与了这项重复测量设计,受试者自身作为对照。受试者穿着左脚鞋,并在右下肢佩戴固态AFO、铰链式AFO或仅穿鞋子在楼梯上行走。使用运动分析设备和测力板收集三种情况下的运动学和动力学数据。比较站立期间的骨盆角度以及右髋、膝和踝关节角度、力矩和功率,以确定不同情况之间的差异。佩戴任何一种矫形器的受试者在上下楼梯时行走速度较慢,下楼时右下肢单支撑时间较短。在上楼的拉起(PU)阶段和下楼的控制下降(CL)阶段,佩戴铰链式AFO或仅穿鞋子的个体的矢状面膝和踝关节角度、力矩和功率相似。与铰链式AFO相比,在PU阶段上楼和CL阶段下楼时,佩戴固态AFO的受试者踝关节背屈角度、跖屈功率、膝关节屈曲角度和伸肌力矩减小。这些发现有助于理解在没有神经肌肉损伤的混杂影响下,单侧固态AFO加于踝关节的生物力学变化如何导致比铰链式AFO更多的动力学和运动学补偿。