van der Krogt Marjolein M, Sloot Lizeth H, Buizer Annemieke I, Harlaar Jaap
Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
J Biomech. 2015 Oct 15;48(13):3577-83. doi: 10.1016/j.jbiomech.2015.07.046. Epub 2015 Aug 14.
Kinetic outcomes are an essential part of clinical gait analysis, and can be collected for many consecutive strides using instrumented treadmills. However, the validity of treadmill kinetic outcomes has not been demonstrated for children with cerebral palsy (CP). In this study we compared ground reaction forces (GRF), center of pressure, and hip, knee and ankle moments, powers and work, between overground (OG) and self-paced treadmill (TM) walking for 11 typically developing (TD) children and 9 children with spastic CP. Considerable differences were found in several outcome parameters. In TM, subjects demonstrated lower ankle power generation and more absorption, and increased hip moments and work. This shift from ankle to hip strategy was likely due to a more backward positioning of the hip and a slightly more forward trunk lean. In mediolateral direction, GRF and hip and knee joint moments were increased in TM due to wider step width. These findings indicate that kinetic data collected on a TM cannot be readily compared with OG data in TD children and children with CP, and that treadmill-specific normative data sets should be used when performing kinetic gait analysis on a treadmill.
动力学结果是临床步态分析的重要组成部分，可使用仪器化跑步机连续收集多个步幅的数据。然而，脑瘫（CP）患儿跑步机动力学结果的有效性尚未得到证实。在本研究中，我们比较了11名发育正常（TD）儿童和9名痉挛型CP儿童在地面行走（OG）和自定步速跑步机（TM）行走时的地面反作用力（GRF）、压力中心以及髋、膝和踝关节的力矩、功率和功。在几个结果参数中发现了显著差异。在跑步机上，受试者表现出较低的踝关节功率产生和更多的吸收，以及增加的髋关节力矩和功。这种从踝关节策略向髋关节策略的转变可能是由于髋关节位置更靠后以及躯干略微前倾。在内外侧方向上，由于步幅变宽，跑步机上的GRF以及髋关节和膝关节力矩增加。这些发现表明，在TD儿童和CP儿童中，跑步机上收集的动力学数据不能轻易与地面行走数据进行比较，并且在跑步机上进行动力学步态分析时应使用特定于跑步机的正常数据集。
