Springer Shmuel, Gottlieb Uri, Lozin Mariya
Department of Physical Therapy, Faculty of Health Science, Ariel University, Ariel, Israel.
Department of Physical Therapy, Faculty of Health Science, Ariel University, Ariel, Israel; Israel Defense Force Medical Corps, Zerifin, Israel.
ScientificWorldJournal. 2016;2016:5939164. doi: 10.1155/2016/5939164. Epub 2016 Jul 13.
The study objective was to determine whether spatiotemporal gait parameters could predict lower-limb overuse injuries in cohort of combat soldiers during first year of military service. Newly recruited infantry soldiers walked on a treadmill at a 15° incline with a fixed speed of 1.67 m/sec while wearing a standard military vest with a 10 kg load. Stride time variability, stride length variability, step length asymmetry, and the duration of the loading response phase of the gait cycle were measured. Injury data on 76 soldiers who did not report musculoskeletal complaints at initial screening were collected one year after recruitment. Multiple logistic regression analyses were conducted to determine the predictive effect of the gait parameters on lower-limb injuries. Twenty-four soldiers (31.6%) had overuse injuries during the first year after recruitment. Duration of the loading response was a significant predictor of general lower-limb injury (p < 0.05), as well as of foot/ankle and knee injuries (p < 0.05, p < 0.01, resp.). A cutoff value of less than 12.15% for loading response duration predicted knee injuries with 83% sensitivity and 67% specificity. This study demonstrates the utility of spatiotemporal gait evaluation, a simple screening tool before military training, which may help to identify individuals at risk of lower-limb overuse injuries.
本研究的目的是确定时空步态参数是否能够预测新兵入伍第一年队列中战斗士兵的下肢过度使用损伤。新招募的步兵士兵穿着带有10千克负载的标准军用背心,以1.67米/秒的固定速度在坡度为15°的跑步机上行走。测量步幅时间变异性、步幅长度变异性、步长不对称性以及步态周期中负重反应阶段的持续时间。在招募一年后收集了76名在初始筛查时未报告肌肉骨骼问题的士兵的损伤数据。进行了多项逻辑回归分析,以确定步态参数对下肢损伤的预测作用。24名士兵(31.6%)在入伍后的第一年出现了过度使用损伤。负重反应的持续时间是下肢总体损伤(p<0.05)以及足部/踝关节和膝关节损伤(分别为p<0.05,p<0.01)的显著预测指标。负重反应持续时间小于12.15%的临界值预测膝关节损伤的灵敏度为83%,特异度为67%。本研究证明了时空步态评估的实用性,这是一种在军事训练前的简单筛查工具,可能有助于识别有下肢过度使用损伤风险的个体。