Ramdharry Gita M, Day Brian L, Reilly Mary M, Marsden Jonathan F
St. George's School of Physiotherapy Kingston University, London, UK.
Muscle Nerve. 2009 Jul;40(1):103-11. doi: 10.1002/mus.21264.
Charcot-Marie-Tooth (CMT) disease results in distal lower limb weakness that affects walking. In this study we assess the role of the hip flexors in compensating for distal weakness while walking and the effects of prolonged walking on these putative compensatory strategies. Eighteen subjects with CMT disease were compared with 14 matched controls while they walked on a treadmill to a predetermined point of perceived effort. A significant reduction was observed in peak hip flexor velocity during walking and hip flexor maximal voluntary contraction. In a second session following selective fatigue of the hip flexors, hip flexor velocity decreased immediately on walking, and walking duration was greatly reduced. This study suggests that hip flexors compensate for distal weakness and that fatigue in the hip flexors can limit walking duration. Treatments directed toward improving proximal muscle strength may therefore help to delay onset of hip flexor fatigue and thus prolong walking duration.
夏科-马里-图思（CMT）病会导致影响行走的下肢远端无力。在本研究中，我们评估了髋屈肌在行走时补偿远端无力的作用以及长时间行走对这些假定补偿策略的影响。18名CMT病患者与14名匹配的对照组在跑步机上行走至预先确定的自觉用力点时进行比较。行走过程中髋屈肌峰值速度和髋屈肌最大自主收缩均显著降低。在髋屈肌选择性疲劳后的第二个阶段，行走时髋屈肌速度立即下降，行走持续时间大幅缩短。本研究表明，髋屈肌可补偿远端无力，且髋屈肌疲劳会限制行走持续时间。因此，旨在提高近端肌肉力量的治疗可能有助于延缓髋屈肌疲劳的发生，从而延长行走持续时间。
