D'Angelo Maria Grazia, Berti Matteo, Piccinini Luigi, Romei Marianna, Guglieri Michela, Bonato Sara, Degrate Alessandro, Turconi Anna Carla, Bresolin Nereo
IRCCS E. Medea, NeuroRehabilitation Department, via don Luigi Monza 20, 23842 Bosisio Parini, Lecco, Italy.
Gait Posture. 2009 Jan;29(1):36-41. doi: 10.1016/j.gaitpost.2008.06.002. Epub 2008 Jul 25.
We investigated the gait pattern of 21 patients with Duchenne muscular dystrophy (DMD), compared to 10 healthy controls through 3D Gait Analysis. An overall observation of gait pattern in our DMD patients when compared to controls confirmed the data previously reported for small dystrophic groups. An excessive anterior tilt of pelvis and abnormal knee pattern in loading response phase were found. Since during the swing phase the DMD foot is too plantarflexed, patients adopt a higher flexion and abduction of the hip in order to advance the swinging limb. Velocity and cadence of DMD patients resulted similar to those calculated for healthy subjects, whereas stride length was reduced and step width was increased. We then divided the DMD patients in to two subgroups (treated with steroids and untreated), and we observed that the only statistically significant differences between the two groups in Gait Analysis parameters were found for the maximum of ankle power. 3D Gait Analysis gives objective and quantitative information about the gait pattern and the deviations due to muscular situation of DMD subjects; being our study a single moment evaluation, it is otherwise unable to unravel changes only detectable through serial analysis during the time course of the disease and, if any, due to the treatment.
我们通过三维步态分析研究了21例杜氏肌营养不良症(DMD)患者的步态模式,并与10名健康对照者进行了比较。与对照组相比,我们对DMD患者步态模式的总体观察证实了先前针对小型营养不良群体报道的数据。发现骨盆过度前倾以及在负重反应阶段存在异常的膝关节模式。由于在摆动阶段DMD患者的足部过度跖屈,患者会采用更高的髋关节屈曲和外展来推进摆动的肢体。DMD患者的速度和步频与健康受试者计算得出的结果相似,而步幅减小,步宽增加。然后我们将DMD患者分为两个亚组(接受类固醇治疗和未接受治疗),并且我们观察到在步态分析参数方面,两组之间唯一具有统计学显著差异的是踝关节功率最大值。三维步态分析提供了有关DMD受试者步态模式以及由于肌肉状况导致的偏差的客观和定量信息;由于我们的研究是单一时刻的评估,否则无法揭示仅通过疾病病程中的系列分析才能检测到的变化,以及(如果有的话)由于治疗引起的变化。