Meyns Pieter, Molenaers Guy, Desloovere Kaat, Duysens Jacques
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
Clinical Motion Analysis Laboratory, CERM, University Hospital Leuven, Leuven, Belgium.
Clin Neurophysiol. 2014 Mar;125(3):552-61. doi: 10.1016/j.clinph.2013.08.022. Epub 2013 Sep 27.
Limb kinematics in backward walking (BW) are essentially those of forward walking (FW) in reverse. It has been argued that subcortical mechanisms could underlie both walking modes.
Therefore, we tested whether participants with supraspinal/cortical deficits (i.e. cerebral palsy) show the kinematic reversal from FW to BW. 3D gait analysis was performed in 15 children with diplegia and 11 children with hemiplegia to record elevation angles of upper arm, lower arm, upper leg, lower leg, and foot, and were compared to those of 23 control subjects. Coordination patterns were compared between FW and BW, and elevation angle traces of BW were reversed in time (revBW) and correlated to FW traces.
The interlimb coordination pattern during BW was largely preserved for all groups. The kinematic reversal of the limbs was also present in children with cerebral palsy (represented by high correlation coefficients between FW and revBW kinematics).
The neural control mechanism of FW leading to BW, is preserved in persons with cortical deficits (as in cerebral palsy).
The current results support previous evidence suggesting that interlimb locomotor coordination depends mostly on the coupling between spinal pattern generators, coordinated by brainstem mechanisms, rather than primarily on cortical structures.
向后行走（BW）时的肢体运动学本质上是向前行走（FW）的反向运动学。有人认为，皮层下机制可能是这两种行走模式的基础。
因此，我们测试了患有脊髓上/皮层缺陷（即脑瘫）的参与者是否表现出从FW到BW的运动学反转。对15名双侧瘫痪儿童和11名单侧瘫痪儿童进行了三维步态分析，以记录上臂、下臂、大腿、小腿和足部的抬高角度，并与23名对照受试者的角度进行比较。比较了FW和BW之间的协调模式，并将BW的抬高角度轨迹进行时间反转（revBW），并与FW轨迹进行相关性分析。
所有组在BW期间的肢体间协调模式基本得以保留。脑瘫儿童也存在肢体的运动学反转（表现为FW和revBW运动学之间的高相关系数）。
导致BW的FW神经控制机制在患有皮层缺陷的人群（如脑瘫患者）中得以保留。
目前的结果支持了先前的证据，表明肢体间运动协调主要取决于由脑干机制协调的脊髓模式发生器之间的耦合，而不是主要取决于皮层结构。
