Centre for Interdisciplinary Research in Rehabilitation, Montreal Rehabilitation Institute, 6300 Darlington Street, Montreal, Canada.
Gait Posture. 2010 Jul;32(3):342-7. doi: 10.1016/j.gaitpost.2010.06.003.
3D analysis of the gait of children with Duchenne muscular dystrophy (DMD) was the topic of only a few studies and none of these considered the effect of gait velocity on the gait parameters of children with DMD. Gait parameters of 11 children with DMD were compared to those of 14 control children while considering the effect of gait velocity using 3D biomechanical analysis. Kinematic and kinetic gait parameters were measured using an Optotrak motion analysis system and AMTI force plates embedded in the floor. The data profiles of children with DMD walking at natural gait velocity were compared to those of the control children who walked at both natural and slow gait velocities. When both groups walked at similar velocity, children with DMD had higher cadence and shorter step length. They demonstrated a lower hip extension moment as well as a minimal or absent knee extension moment. At the ankle, a dorsiflexion moment was absent at heel strike due to the anterior location of the center of pressure. The magnitude of the medio-lateral ground reaction force was higher in children with DMD. Despite this increase, the hip abductor moment was lower. Hip power generation was also observed at the mid-stance in DMD children. These results suggest that most of the modifications observed are strategies used by children with DMD to cope with possible muscle weakness in order to provide support, propulsion and balance of the body during gait.
3D 分析杜氏肌营养不良症(DMD)患儿的步态,仅有少数研究涉及,且没有研究考虑步态速度对 DMD 患儿步态参数的影响。本研究使用三维生物力学分析,考虑步态速度的影响,比较了 11 名 DMD 患儿与 14 名正常儿童的步态参数。使用 Optotrak 运动分析系统和嵌入在地板上的 AMTI 测力板测量运动学和动力学步态参数。将自然步态速度行走的 DMD 患儿的数据与以自然和慢速度行走的对照组儿童的数据进行比较。当两组以相似的速度行走时,DMD 患儿的步频更高,步长更短。他们的髋关节伸展力矩更低,膝关节伸展力矩几乎为零或不存在。在踝关节,由于压力中心的前置位置,足跟触地时没有背屈力矩。DMD 患儿的中-外侧地面反作用力更大。尽管有这种增加,但髋关节外展力矩却更低。在 DMD 患儿的支撑中期也观察到髋关节的功率产生。这些结果表明,大多数观察到的改变是 DMD 患儿为了在步态中提供支撑、推进和平衡身体而使用的策略,以应对可能的肌肉无力。