Mirek Elzbieta, Filip Magdalena, Chwała Wiesław, Banaszkiewicz Krzysztof, Rudzinska-Bar Monika, Szymura Jadwiga, Pasiut Szymon, Szczudlik Andrzej
Department of Clinical Rehabilitation and Laboratory of Pathology of the Musculoskeletal System, University School of Physical Education, Cracow, Poland.
Department of Anthropomotorics, University School of Physical Education, Cracow, Poland.
Front Neurosci. 2017 Oct 12;11:566. doi: 10.3389/fnins.2017.00566. eCollection 2017.
A number of studies on gait disturbances have been conducted, however, no clear pattern of gait disorders was described. The aim of the study was to characterize the gait pattern in HD patients by conducting analysis of mean angular movement changes the lower limb joints and trunk (kinematics parameters). The study group consisted of 30 patients with HD (17 women and 13 men). The reference data include the results of 30 healthy subjects (17 women and 13 men). Registration of gait with the Vicon 250 system was performed using passive markers attached to specific anthropometric points directly on the skin, based on the Golem biomechanical model (Oxford Metrics Ltd.). The research group and the control group were tested once. Statistically significant ( < 0.05) angular changes in gait cycle for HD patients were observed in: insufficient plantar flexion during Loading Response and Pre-swing phases; insufficient flexion of the knee joint during Initial Swing and Mid Swing phases; excessive flexion of the hip in Terminal Stance and Pre-swing phases and over-normative forward inclination of the trunk in all gait phases. It should be noted that the group of patients with HD obtained, for all the mean angular movement changes higher standard deviation. A characteristic gait disorder common to all patients with HD occurring throughout the whole duration of the gait cycle is a pathological anterior tilt of the trunk. The results will significantly contribute to programming physiotherapy for people with HD, aimed at stabilizing the trunk in a position of extension during gait.
已经开展了多项关于步态障碍的研究，然而，尚未描述出明确的步态障碍模式。本研究的目的是通过分析下肢关节和躯干的平均角运动变化（运动学参数）来描述亨廷顿舞蹈症（HD）患者的步态模式。研究组由30名HD患者组成（17名女性和13名男性）。参考数据包括30名健康受试者的结果（17名女性和13名男性）。基于Golem生物力学模型（牛津测量有限公司），使用直接附着在皮肤上特定人体测量点的被动标记，通过Vicon 250系统进行步态记录。研究组和对照组均接受了一次测试。在HD患者的步态周期中观察到具有统计学意义（<0.05）的角度变化：在负重反应和摆动前期足底屈曲不足；在初始摆动期和摆动中期膝关节屈曲不足；在终末站立期和摆动前期髋关节过度屈曲，以及在所有步态阶段躯干前倾超过正常范围。应当指出的是，HD患者组在所有平均角运动变化方面获得的标准差更高。在整个步态周期中，所有HD患者共有的一种特征性步态障碍是躯干病理性前倾。这些结果将对为HD患者制定物理治疗方案做出重大贡献，该方案旨在使患者在步态过程中将躯干稳定在伸展位置。
