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遗传性肥胖患者的步态策略:7年随访

Gait strategy in genetically obese patients: a 7-year follow up.

作者信息

Cimolin V, Vismara L, Galli M, Grugni G, Cau N, Capodaglio P

机构信息

Department of Electronics, Information and Bioengineering, Politecnico di Milano, p.zza Leonardo Da Vinci 32, 20133 Milano, Italy.

Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824 Piancavallo, VB, Italy.

出版信息

Res Dev Disabil. 2014 Jul;35(7):1501-6. doi: 10.1016/j.ridd.2014.04.005. Epub 2014 Apr 21.

Abstract

The aim of this study was to quantitatively evaluate the change in gait and body weight in the long term in patients with Prader-Willi Syndrome (PWS). Eight adults with PWS were evaluated at baseline and after 7 years. During this period patient participated an in- and out-patient rehabilitation programs including nutritional and adapted physical activity interventions. Two different control groups were included: the first group included 14 non-genetically obese patients (OCG: obese control group) and the second group included 10 age-matched healthy individuals (HCG: healthy control group). All groups were quantitatively assessed during walking with 3D-GA. The results at the 7-year follow-up revealed significant weight loss in the PWS group and spatial-temporal changes in gait parameters (velocity, step length and cadence). With regard to the hip joint, there were significant changes in terms of hip position, which is less flexed. Knee flexion-extension showed a reduction of flexion in swing phase and of its excursion. No changes of the ankle position were evident. As for ankle kinetics, we observed in the second session higher values for the peak of ankle power in terminal stance in comparison to the first session. No changes were found in terms of ankle kinetics. The findings demonstrated improvements associated to long-term weight loss, especially in terms of spatial-temporal parameters and at hip level. Our results back the call for early weight loss interventions during childhood, which would allow the development of motor patterns under normal body weight conditions.

摘要

本研究的目的是定量评估普拉德-威利综合征(PWS)患者长期的步态和体重变化。对8名成年PWS患者在基线期和7年后进行了评估。在此期间,患者参与了门诊和住院康复项目,包括营养和适应性体育活动干预。纳入了两个不同的对照组:第一组包括14名非遗传性肥胖患者(OCG:肥胖对照组),第二组包括10名年龄匹配的健康个体(HCG:健康对照组)。所有组在行走过程中均采用三维步态分析(3D-GA)进行定量评估。7年随访结果显示,PWS组体重显著减轻,步态参数(速度、步长和步频)出现时空变化。关于髋关节,髋关节位置有显著变化,屈曲程度降低。膝关节屈伸在摆动期的屈曲及其偏移量减少。踝关节位置无明显变化。至于踝关节动力学,我们观察到在第二个测试阶段与第一个测试阶段相比,终末支撑期踝关节功率峰值更高。在踝关节动力学方面未发现变化。研究结果表明与长期体重减轻相关的改善,特别是在时空参数和髋关节水平方面。我们的结果支持在儿童期进行早期体重减轻干预的呼吁,这将有助于在正常体重条件下发展运动模式。

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