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肌肉力量对不同患者步态曲线评分(GPS)的影响。

The influence of muscle strength on the gait profile score (GPS) across different patients.

机构信息

Laboratory for Movement Analysis, University Children's Hospital Basel (UKBB), Switzerland; Clinical Morphology and Biomedical Engineering, University of Basel, Switzerland.

出版信息

Gait Posture. 2014 Jan;39(1):80-5. doi: 10.1016/j.gaitpost.2013.06.001. Epub 2013 Jun 28.

Abstract

BACKGROUND

Muscle strength greatly influences gait kinematics. The question was whether this association is similar in different diseases.

METHODS

Data from instrumented gait analysis of 716 patients were retrospectively assessed. The effect of muscle strength on gait deviations, namely the gait profile score (GPS) was evaluated by means of generalised least square models. This was executed for seven different patient groups. The groups were formed according to the type of disease: orthopaedic/neurologic, uni-/bilateral affection, and flaccid/spastic muscles.

RESULTS

Muscle strength had a negative effect on GPS values, which did not significantly differ amongst the different patient groups. However, an offset of the GPS regression line was found, which was mostly dependent on the basic disease. Surprisingly, spastic patients, who have reduced strength and additionally spasticity in clinical examination, and flaccid neurologic patients showed the same offset. Patients with additional lack of trunk control (Tetraplegia) showed the largest offset.

CONCLUSION

Gait kinematics grossly depend on muscle strength. This was seen in patients with very different pathologies. Nevertheless, optimal correction of biomechanics and muscle strength may still not lead to a normal gait, especially in that of neurologic patients. The basic disease itself has an additional effect on gait deviations expressed as a GPS-offset of the linear regression line.

摘要

背景

肌肉力量对步态运动学有很大影响。问题是这种关联在不同疾病中是否相似。

方法

回顾性评估了 716 名患者的仪器步态分析数据。通过广义最小二乘模型评估肌肉力量对步态偏差的影响,即步态轮廓评分(GPS)。这是针对七个不同的患者群体进行的。根据疾病类型形成了这些群体:骨科/神经科、单侧/双侧影响以及弛缓/痉挛性肌肉。

结果

肌肉力量对 GPS 值有负面影响,但在不同的患者群体中差异不显著。然而,发现 GPS 回归线存在偏移,这主要取决于基础疾病。令人惊讶的是,痉挛性患者(在临床检查中肌肉力量减弱且同时伴有痉挛)和弛缓性神经科患者表现出相同的偏移。此外,缺乏躯干控制(四肢瘫痪)的患者显示出最大的偏移。

结论

步态运动学严重依赖于肌肉力量。这在具有非常不同病理的患者中可见。然而,即使对生物力学和肌肉力量进行最佳矫正,也可能无法导致正常的步态,尤其是在神经科患者中。基础疾病本身对步态偏差有额外的影响,表现为线性回归线的 GPS 偏移。

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