Sloot Lizeth H, Harlaar Jaap, van der Krogt Marjolein M
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.
Gait Posture. 2015 Oct;42(4):498-504. doi: 10.1016/j.gaitpost.2015.08.003. Epub 2015 Aug 18.
While feedback-controlled treadmills with a virtual reality could potentially offer advantages for clinical gait analysis and training, the effect of self-paced walking and the virtual environment on the gait pattern of children and different patient groups remains unknown. This study examined the effect of self-paced (SP) versus fixed speed (FS) walking and of walking with and without a virtual reality (VR) in 11 typically developing (TD) children and nine children with cerebral palsy (CP). We found that subjects walked in SP mode with twice as much between-stride walking speed variability (p<0.01), fluctuating over multiple strides. There was no main effect of SP on kinematics or kinetics, but small interaction effects between SP and group (TD versus CP) were found for five out of 33 parameters. This suggests that children with CP might need more time to familiarize to SP walking, however, these differences were generally too small to be clinically relevant. The VR environment did not affect the kinematic or kinetic parameters, but walking with VR was rated as more similar to overground walking by both groups (p=0.02). The results of this study indicate that both SP and FS walking, with and without VR, can be used interchangeably for treadmill-based clinical gait analysis in children with and without CP.
虽然带有虚拟现实的反馈控制跑步机可能为临床步态分析和训练带来优势，但自主步速行走和虚拟环境对儿童及不同患者群体步态模式的影响仍不清楚。本研究调查了11名发育正常（TD）儿童和9名脑瘫（CP）儿童在自主步速（SP）与固定速度（FS）行走以及有无虚拟现实（VR）环境下行走的影响。我们发现，受试者在SP模式下行走时，步幅间行走速度变异性是原来的两倍（p<0.01），且在多个步幅上波动。SP对运动学或动力学没有主要影响，但在33个参数中的5个参数上发现了SP与组别（TD与CP）之间的微小交互作用。这表明脑瘫儿童可能需要更多时间来适应SP行走，然而，这些差异通常太小，不具有临床相关性。VR环境并未影响运动学或动力学参数，但两组均认为在VR环境下行走与在地面行走更相似（p=0.02）。本研究结果表明，无论有无VR，SP和FS行走均可互换用于有或无CP儿童的基于跑步机的临床步态分析。
