Serrao Mariano, Chini Giorgia, Iosa Marco, Casali Carlo, Morone Giovanni, Conte Carmela, Bini Fabiano, Marinozzi Franco, Coppola Gianluca, Pierelli Francesco, Draicchio Francesco, Ranavolo Alberto
Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Via Faggiana 34, 40100 Latina, Italy; Rehabilitation Centre Policlinico Italia, Piazza del Campidano 6, 00162 Rome, Italy.
Biolab3, Department of Engineering, Roma TRE University, Via Vito Volterra 62, 00149 Roma, Italy.
Clin Biomech (Bristol). 2017 Oct;48:15-23. doi: 10.1016/j.clinbiomech.2017.07.001. Epub 2017 Jul 5.
The harmony of the human gait was recently found to be related to the golden ratio value (ϕ). The ratio between the duration of the stance and that of the swing phases of a gait cycle was in fact found to be close to ϕ, which implies that, because of the fractal property of autosimilarity of that number, the gait ratios stride/stance, stance/swing, swing/double support, were not significantly different from one another. We studied a group of patients with cerebellar ataxia to investigate how the differences between their gait ratios and the golden ratio are related to efficiency and stability of their gait, assessed by energy expenditure and stride-to-stride variability, respectively.
The gait of 28 patients who were affected by degenerative cerebellar ataxia and of 28 healthy controls was studied using a stereophotogrammetric system. The above mentioned gait ratios, the energy expenditure estimated using the pelvis reconstructed method and the gait variability in terms of the stride length were computed, and their relationships were analyzed. Matching procedures have also been used to avoid multicollinearity biases.
The gait ratio values of the patients were farther from the controls (and hence from ϕ), even in speed matched conditions (P=0.011, Cohen's D=0.76), but not when the variability and energy expenditure were matched between the two groups (Cohen's D=0.49). In patients with cerebellar ataxia, the farther the stance-swing ratio was from ϕ, the larger the total mechanical work (R=0.64). Further, a significant positive correlation was observed between the difference of the gait ratio from the golden ratio and the severity of the disease (R=0.421, P=0.026).
Harmony of gait appears to be a benchmark of physiological gait leading to physiological energy recovery and gait reliability. Neurorehabilitation of patients with ataxia might benefit from the restoration of harmony of their locomotor patterns.
最近发现人类步态的协调性与黄金分割值（ϕ）有关。实际上，人们发现步态周期中站立期与摆动期的时长之比接近ϕ，这意味着，由于该数字的自相似分形特性，步幅/站立、站立/摆动、摆动/双支撑的步态比率彼此之间没有显著差异。我们研究了一组小脑共济失调患者，以调查他们的步态比率与黄金分割率之间的差异如何分别通过能量消耗和步幅间变异性来评估与步态效率和稳定性相关。
使用立体摄影测量系统研究了28例退行性小脑共济失调患者和28例健康对照者的步态。计算上述步态比率、使用骨盆重建方法估算的能量消耗以及步幅方面的步态变异性，并分析它们之间的关系。还采用了匹配程序以避免多重共线性偏差。
即使在速度匹配的情况下，患者的步态比率值也比对照组（因此也比ϕ）更远（P = 0.011，科恩d值 = 0.76），但当两组之间的变异性和能量消耗匹配时则不然（科恩d值 = 0.49）。在小脑共济失调患者中，站立-摆动比率离ϕ越远，总机械功就越大（R = 0.64）。此外，观察到步态比率与黄金分割率的差异与疾病严重程度之间存在显著正相关（R = 0.421，P = 0.026）。
步态协调性似乎是生理步态的一个基准，可实现生理能量恢复和步态可靠性。共济失调患者的神经康复可能会受益于其运动模式协调性的恢复。
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