Melai Tom, Schaper Nicolaas C, IJzerman T Herman, Willems Paul J B, de Lange Tom L H, Meijer Kenneth, Lieverse Aloysius G, Savelberg Hans H C M
Department of Health Innovation & Technology, Institute of Allied Health Professions, Fontys University of Applied Sciences, Eindhoven, The Netherlands.
J Appl Biomech. 2014 Apr;30(2):221-30. doi: 10.1123/jab.2013-0186. Epub 2013 Sep 13.
Increased forefoot loading in diabetic polyneuropathy plays an important role in the development of plantar foot ulcers and can originate from alterations in muscle strength, joint moments and gait pattern. The current study evaluated whether strength training can improve lower extremity joint moments and spatiotemporal gait characteristics in patients with diabetic polyneuropathy. An intervention group receiving strength training during 24 weeks and a control group receiving no intervention. Measurements were performed in both groups at t=0, t=12, t=24 and t=52 weeks at an individually preferred and standardized imposed gait velocity. The strength training did not affect the maximal amplitude of hip, knee and ankle joint moments, but did result in an increase in stance phase duration, stride time and stride length of approximately 5%, during the imposed gait velocity. In addition, both groups increased their preferred gait velocity over one year. Future longitudinal studies should further explore the possible effects of strength training on spatiotemporal gait characteristics. The current study provides valuable information on changes in gait velocities and the progressive lower extremity problems in patients with polyneuropathy.
糖尿病性多发性神经病变中前足负荷增加在足底溃疡的发生发展中起重要作用，且可能源于肌肉力量、关节力矩和步态模式的改变。本研究评估了力量训练是否能改善糖尿病性多发性神经病变患者的下肢关节力矩和时空步态特征。一组干预组接受为期24周的力量训练，另一对照组不接受干预。在t = 0、t = 12、t = 24和t = 52周时，对两组患者在各自偏好的和标准化的规定步态速度下进行测量。力量训练并未影响髋、膝和踝关节力矩的最大幅度，但在规定步态速度期间，确实导致站立相持续时间、步幅时间和步幅长度增加了约5%。此外，两组患者在一年时间里都提高了各自偏好的步态速度。未来的纵向研究应进一步探讨力量训练对时空步态特征可能产生的影响。本研究提供了关于步态速度变化以及多发性神经病变患者下肢渐进性问题的有价值信息。
