Rui Jing, Runge M Brett, Spinner Robert J, Yaszemski Michael J, Windebank Anthony J, Wang Huan
From the *Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; †Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; ‡Departments of Orthopedic Surgery and Biomedical Engineering, and §Department of Neurology, Mayo Clinic, Rochester, MN; and ∥Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, People's Republic of China.
Ann Plast Surg. 2014 Oct;73(4):405-11. doi: 10.1097/SAP.0000000000000008.
Video-assisted gait kinetics analysis has been a sensitive method to assess rat sciatic nerve function after injury and repair. However, in conduit repair of sciatic nerve defects, previously reported kinematic measurements failed to be a sensitive indicator because of the inferior recovery and inevitable joint contracture.
This study aimed to explore the role of physiotherapy in mitigating joint contracture and to seek motion analysis indices that can sensitively reflect motor function.
Data were collected from 26 rats that underwent sciatic nerve transection and conduit repair. Regular postoperative physiotherapy was applied. Parameters regarding step length, phase duration, and ankle angle were acquired and analyzed from video recording of gait kinetics preoperatively and at regular postoperative intervals.
Stride length ratio (step length of uninjured foot/step length of injured foot), percent swing of the normal paw (percentage of the total stride duration when the uninjured paw is in the air), propulsion angle (toe-off angle subtracted by midstance angle), and clearance angle (ankle angle change from toe off to midswing) decreased postoperatively comparing with baseline values. The gradual recovery of these measurements had a strong correlation with the post-nerve repair time course.
Ankle joint contracture persisted despite rigorous physiotherapy. Parameters acquired from a 2-dimensional motion analysis system, that is, stride length ratio, percent swing of the normal paw, propulsion angle, and clearance angle, could sensitively reflect nerve function impairment and recovery in the rat sciatic nerve conduit repair model despite the existence of joint contractures.
视频辅助步态动力学分析一直是评估大鼠坐骨神经损伤和修复后功能的一种敏感方法。然而，在坐骨神经缺损的导管修复中，由于恢复较差和不可避免的关节挛缩，先前报道的运动学测量未能成为一个敏感指标。
本研究旨在探讨物理治疗在减轻关节挛缩中的作用，并寻找能敏感反映运动功能的运动分析指标。
收集26只接受坐骨神经切断和导管修复的大鼠的数据。术后进行常规物理治疗。从术前和术后定期的步态动力学视频记录中获取并分析步长、相持续时间和踝关节角度等参数。
与基线值相比，术后步长比（健侧足步长/患侧足步长）、正常爪摆动百分比（健侧爪在空中时占总步长时间的百分比）、推进角（足跟离地角减去支撑中期角）和间隙角（从足跟离地到摆动中期的踝关节角度变化）均下降。这些测量值的逐渐恢复与神经修复后的时间进程密切相关。
尽管进行了严格的物理治疗，踝关节挛缩仍然存在。在大鼠坐骨神经导管修复模型中，尽管存在关节挛缩，但从二维运动分析系统获得的参数，即步长比、正常爪摆动百分比、推进角和间隙角，能够敏感地反映神经功能损伤和恢复情况。
