Lang Juntian, Ishikawa Kazuo, Hatakeyama Kazutoshi, Wong Weng Hoe, Yin Min, Saito Takashi, Sibata Yutaka
Department of Otorhinolaryngology, Akita University, School of Medicine, Hondo, Akita, Japan.
Auris Nasus Larynx. 2013 Feb;40(1):18-24. doi: 10.1016/j.anl.2011.11.007. Epub 2012 Jun 15.
To investigate the patterns of gait and locomotion in three dimension space in patients with vestibular disorders.
A 3D motion analysis system was employed to evaluate locomotor pattern and body's oscillation during gait under different conditions (normal, slow, fast speeds walking with eye open and normal speed walking with eyes closed) of nine patients with vestibular disorders. Twenty-one markers placed on the subject to record kinematics and locomotions of the head, spine and pelvis segments while walking. For each locomotor trial, the walking speed, locomotor patterns as well as the absolute angular dispersions of six segments around the roll, pitch and yaw axes were calculated to assess the equilibrium strategies of head, trunk and pelvis. Data was also recorded in 10 healthy subjects as control.
Patients' cadence is faster, and the stride time at normal walking speed is shorter than that of the controls (p<0.05). The body sway has also been documented some impairment in patients. With respect to the control, patients' oscillation of trunk around yaw axis at fast speed is less (p<0.05), which means the patient seems need less shoulder torsional movement. Moreover, the most prominent changes in patients are the sway of hip in roll, which is significant less than controls at fast (p<0.01), slow speed (p<0.01) and in eye-closed condition (p<0.05).
Our investigation corroborates those reports that higher velocities would be helpful for the increased gait stability in patients with vestibular disorders. And the body always try to keep the stability of head during gait, even under vestibular deficit conditions.
研究前庭障碍患者在三维空间中的步态和运动模式。
采用三维运动分析系统,评估9例前庭障碍患者在不同条件下(正常、慢速、快速睁眼行走以及正常速度闭眼行走)步态期间的运动模式和身体摆动情况。在受试者身上放置21个标记,以记录行走时头部、脊柱和骨盆节段的运动学和运动情况。对于每次运动试验,计算行走速度、运动模式以及六个节段围绕横滚、俯仰和偏航轴的绝对角离散度,以评估头部、躯干和骨盆的平衡策略。还记录了10名健康受试者的数据作为对照。
患者的步频更快,正常行走速度下的步幅时间比对照组短(p<0.05)。患者的身体摆动也有一定程度的受损。与对照组相比,患者快速行走时躯干围绕偏航轴的摆动较小(p<0.05),这意味着患者似乎需要较少的肩部扭转运动。此外,患者最显著的变化是髋关节在横滚方向的摆动,在快速(p<0.01)、慢速(p<0.01)和闭眼状态下(p<0.05)均显著小于对照组。
我们的研究证实了那些报告,即较高速度有助于提高前庭障碍患者的步态稳定性。并且即使在前庭功能缺失的情况下,身体在步态过程中也总是试图保持头部的稳定。