Attias Michael, Chevalley Odile, Bonnefoy-Mazure Alice, De Coulon Geraldo, Cheze Laurence, Armand Stéphane
Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland; HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland; Université Claude Bernard Lyon 1, Villeurbanne, France.
Bern University of Applied Sciences Bern, Switzerland.
Clin Biomech (Bristol). 2016 Mar;33:103-110. doi: 10.1016/j.clinbiomech.2016.02.017. Epub 2016 Mar 2.
Contractures of a major joint in the lower limbs may impair human walking in addition to other daily living activities. A contracture is defined as the inability of a joint to perform the full range of motion and excessive resistance during passive mobilization of the joint. Few studies have reported methods describing how to evaluate contractures. Understanding the association among all of these studies seems essential to improve patient management. Therefore, we conducted a systematic review on this topic to elucidate the influence of contractures on gait kinematics.
An electronic search in the literature will be conducted. Studies were screened by title and abstract and full texts were evaluated secondarily for definitive inclusion. The quality of the included studies was assessed independently by the two review authors with the Modified Quality Assessment Checklist. The included studies were separated into three categories: pathological contracture versus healthy controls (descriptive), simulated contracture versus healthy controls (experimental), and pre- and post-kinematics after surgical muscle lengthening (surgery).
From a total of 4402 references, 112 original articles were selected, and 28 studies were identified in this systematic review. No significant difference between raters was observed on the total score of the Modified Quality Assessment Checklist.
Contractures influence walking depending on the location (muscle) and the contracture level (muscle-tendon length). After giving a definition of contracture, this review identified some contracture alterations, such as plantarflexion, knee flexion and hip flexion contractures, with a kinematic description and presented possible different compensations.
下肢主要关节的挛缩除了会影响其他日常生活活动外，还可能损害人类行走。挛缩被定义为关节在被动活动时无法完成全范围运动且存在过度阻力。很少有研究报道描述如何评估挛缩的方法。了解所有这些研究之间的关联对于改善患者管理似乎至关重要。因此，我们针对该主题进行了一项系统综述，以阐明挛缩对步态运动学的影响。
将对文献进行电子检索。通过标题和摘要筛选研究，并对全文进行二次评估以确定最终纳入情况。两位综述作者使用改良质量评估清单独立评估纳入研究的质量。纳入研究分为三类：病理性挛缩与健康对照（描述性）、模拟挛缩与健康对照（实验性）以及手术肌肉延长后的运动学前后对比（手术）。
从总共4402篇参考文献中，选择了112篇原创文章，在本系统综述中确定了28项研究。在改良质量评估清单的总分上，评估者之间未观察到显著差异。
挛缩对行走的影响取决于位置（肌肉）和挛缩程度（肌腱长度）。在给出挛缩的定义后，本综述确定了一些挛缩改变，如跖屈、膝关节屈曲和髋关节屈曲挛缩，并进行了运动学描述，还介绍了可能的不同代偿情况。
