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抗扰步行:摆动期踝关节背屈肌激活的影响及康复潜力。

Walking while resisting a perturbation: Effects on ankle dorsiflexor activation during swing and potential for rehabilitation.

机构信息

Multidisciplinary Team in Locomotor Rehabilitation, Montreal, Canada.

出版信息

Gait Posture. 2011 Jul;34(3):358-63. doi: 10.1016/j.gaitpost.2011.06.001. Epub 2011 Jul 6.

Abstract

UNLABELLED

Motor control studies have shown that when walking is performed while resisting a perturbation applied to the lower limb, the muscle activation pattern can be temporarily modified. The objective of the present study is to validate if such an approach, targeting the ankle, could specifically promote an increased activation of the ankle dorsiflexor muscles that are of key importance for the rehabilitation of foot drop.

METHODS

12 adults, with no gait deficit, walked on a treadmill for three periods of 5min: before, during and after exposure to a torque perturbation applied by a robotized ankle-foot orthosis that tended to plantarflex the ankle during the swing phase. Spatiotemporal gait parameters, ankle and knee kinematics, and the electromyographic activity of five lower limb muscle groups were recorded.

RESULTS

The perturbation initially caused a deviation of the ankle towards plantarflexion. This movement error was rapidly reduced and associated with a large increase (78.2%; p<0.001) in tibialis anterior (ankle dorsiflexor; TA) activation, specifically in the stance-to-swing burst. This increase carried over to post-perturbation walking, gradually disappearing over several strides. Interestingly, these aftereffects led to an increase in peak ankle dorsiflexion of approximately 7° during the swing phase.

CONCLUSIONS

Walking while resisting a torque perturbation applied at the ankle during swing promotes an increase in TA muscle activation that carries over after perturbation removal, leading to an increased ankle dorsiflexion. Training based on this approach may have the potential of improving the gait of persons with foot drop.

摘要

目的

研究表明,当人在抵抗施加于下肢的外力时行走,肌肉激活模式会暂时改变。本研究旨在验证这种针对踝关节的方法是否能特别促进对踝背屈肌的激活,踝背屈肌对治疗足下垂非常重要。

方法

12 名无步态缺陷的成年人在跑步机上行走 3 个 5 分钟周期:在机器人踝足矫形器施加的转矩干扰前、期间和后。记录时空步态参数、踝关节和膝关节运动学以及 5 个下肢肌肉群的肌电图活动。

结果

干扰最初导致踝关节向跖屈方向偏离。这种运动误差很快被纠正,并且伴随着胫骨前肌(踝背屈肌;TA)激活的大幅增加(78.2%;p<0.001),特别是在站立到摆动爆发期间。这种增加持续到干扰后的行走,逐渐在几个步态中消失。有趣的是,这些后效导致摆动阶段的踝关节背屈峰值增加约 7°。

结论

在摆动时抵抗施加于踝关节的转矩干扰会促进 TA 肌肉的激活增加,这种增加会在干扰去除后持续存在,从而增加踝关节背屈。基于这种方法的训练可能有潜力改善足下垂患者的步态。

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