Fischer Arielle G, Wolf Alon
Department of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa, Israel.
Department of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa, Israel.
Clin Biomech (Bristol). 2015 Jun;30(5):454-61. doi: 10.1016/j.clinbiomech.2015.03.010. Epub 2015 Mar 14.
Gait rehabilitation with body weight unloading is a common method of gait rehabilitation for clinical subjects with neurological and musculoskeletal impairments. However, the efficiency of this method was hard to assess given the confounding variables walking modality (treadmill vs. overground) and subjects' inability to maintain a comfortable speed when pulling a body weight unloading system by which they were suspended. By controlling the gait modality (overground) and devising a mechanical device that pulled the system at a constant speed, this study could examine the unique effects of body weight unloading on the biomechanical parameters of healthy subjects walking overground at comfortable speed.
Ten healthy subjects were instructed to walk overground under a control (no suspension vest) and three (0%, 15%, 30%) body weight unloading experimental conditions. Hip, knee and ankle spatiotemporal, kinematic, and kinetic measures were recorded for all conditions (six trials per condition).
ANOVA showed no changes in cadence, speed and stride length, a reduction in double limb support and increase in single limb support. Pairwise comparisons of gait parameters under 0%,15% and 30% body weight unloading conditions indicated significant reductions in lower joint kinematics and kinetics with increased body weight unloading. Additionally, despite changes in the peak values of kinematic and kinetic measures, the curvature patterns remained unchanged.
This study shows that overground gait with up to 30% body weight unloading reduces joint loads without modifying gait curvature patterns or the plantarflexion angle. Several clinical applications for gait reeducation conducted in situ with unloading are enumerated.
对于患有神经和肌肉骨骼损伤的临床受试者,采用体重支撑减轻的步态康复是一种常见的步态康复方法。然而,鉴于混杂变量行走方式(跑步机与地面行走)以及受试者在拉动用于悬吊他们的体重支撑减轻系统时无法保持舒适速度,这种方法的效率难以评估。通过控制步态方式(地面行走)并设计一种以恒定速度拉动系统的机械设备,本研究能够检验体重支撑减轻对以舒适速度在地面行走的健康受试者生物力学参数的独特影响。
10名健康受试者被要求在对照(无悬吊背心)和三种(0%、15%、30%)体重支撑减轻实验条件下在地面行走。记录所有条件下(每种条件进行6次试验)髋、膝和踝关节的时空、运动学和动力学测量值。
方差分析显示步频、速度和步长无变化,双支撑期减少,单支撑期增加。在0%、15%和30%体重支撑减轻条件下对步态参数进行两两比较表明,随着体重支撑减轻增加,下肢关节运动学和动力学显著降低。此外,尽管运动学和动力学测量值的峰值有所变化,但曲率模式保持不变。
本研究表明,体重支撑减轻高达30%的地面行走可降低关节负荷,而不会改变步态曲率模式或跖屈角度。列举了几种在原地进行卸载步态再教育的临床应用。