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转弯和直线步态中的局部动态稳定性。

Local dynamic stability in turning and straight-line gait.

作者信息

Segal Ava D, Orendurff Michael S, Czerniecki Joseph M, Shofer Jane B, Klute Glenn K

机构信息

Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Rehabilitation Research and Development, Veterans Administration Puget Sound Health Care System, Seattle, WA, USA.

出版信息

J Biomech. 2008;41(7):1486-93. doi: 10.1016/j.jbiomech.2008.02.012. Epub 2008 Apr 10.

Abstract

Successful community and household ambulation require the ability to navigate corners and maneuver around obstacles, posing unique challenges compared to straight-line walking. The challenges associated with turning may contribute to an increased incidence of falling and the occurrence of fall-related injuries. A measure of stability applied to turning gait may be able to quantify a system's response to naturally occurring disturbances associated with turning and identify subjects at greater risk of falling. An index of stability has been used previously to assess the rate of kinematic separation (local dynamic stability) during straight-line gait. The purpose of this study was to determine if local dynamic stability during constant speed turning is reduced compared to straight-line treadmill walking. Maximum finite-time Lyapunov exponents (lambda) were used to estimate the local stability of able-bodied subjects' (n=19) sagittal plane hip, knee, and ankle trajectories for turning compared to straight-line walking at two different walking speeds. Turning lambda was greater than straight lambda for the hip, right knee, and ankle (p<0.05). Turning lambda for the left knee angle was similar to straight lambda. There were no differences in lambda between left and right limbs for the hip and ankle and also no differences between the inside and outside limbs during turning for all joints. These findings indicate able-bodied subjects' hip, right knee, and ankle kinematics are less locally stable while turning than walking in a straight line and may be used as a comparative tool for determining the efficacy of therapeutic interventions for mobility-impaired populations.

摘要

成功的社区和家庭行走需要具备在拐角处导航并绕过障碍物的能力,这与直线行走相比带来了独特的挑战。与转弯相关的挑战可能会导致跌倒发生率增加以及与跌倒相关的伤害发生。应用于转弯步态的稳定性测量可能能够量化系统对与转弯相关的自然干扰的反应,并识别出跌倒风险更高的受试者。先前已使用稳定性指数来评估直线步态期间的运动学分离率(局部动态稳定性)。本研究的目的是确定与直线跑步机行走相比,恒速转弯期间的局部动态稳定性是否降低。使用最大有限时间李雅普诺夫指数(lambda)来估计19名健全受试者在两个不同步行速度下转弯与直线行走时矢状面髋、膝和踝关节轨迹的局部稳定性。髋、右膝和踝关节的转弯lambda大于直线lambda(p<0.05)。左膝角度的转弯lambda与直线lambda相似。髋和踝关节左右肢体之间的lambda没有差异,并且在所有关节转弯期间内外肢体之间也没有差异。这些发现表明,健全受试者在转弯时髋、右膝和踝关节的运动学局部稳定性低于直线行走,并且可作为确定针对行动不便人群的治疗干预效果的比较工具。

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