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形态功能肌肉变化对多发性硬化症患者步态预测中足部稳定性的影响:康复潜力。

Morphofunctional muscle changes influence on foot stability in multiple sclerosis during gait prediction: The rehabilitation potential.

作者信息

Neamtu Marius Cristian, Neamtu Oana Maria, Marin Mihnea Ion, Rusu Ligia

机构信息

Department of Pathologic Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.

Department of Sports Medicine and Kinesiology, University of Craiova, Craiova, Romania.

出版信息

J Back Musculoskelet Rehabil. 2018;31(3):469-474. doi: 10.3233/BMR-170925.

Abstract

BACKGROUND

Multiple sclerosis patients may suffer muscle changes that involve gait disorders of the kinetic and kinematic parameters also their gait may be clinically symmetrical or asymmetrical.

OBJECTIVE

The aim of this study is to analyze how the muscle change, could affect the biomechanical parameters of foot stability during the gait, by disturb the motor control.

METHODS

The study group consisted of 13 patients diagnosed with multiple sclerosis, presenting clinically detectable abnormal gait. The biomechanical evaluation included the foot axes and angles -external and internal rotation; the foot angle deviation from the gait direction; the subtalar angle.

RESULTS

The values of the foot angle were between -10.74∘ to 26.38∘ for the left foot and between -11.16∘ to 30.04∘ for the right foot. The foot axis angle is the axis of the foot in relation to the gait direction, and the subtalar angle is in relation to the vertical axis of the foot. The rotation of the right foot into pronation during the initial contact phase was followed by supination in the semi-support phase, to return to the neutral position during the propulsion phase, which meant being in free zone of minimal risk.

CONCLUSIONS

Biomechanical analysis of the foot angle and of subtalar angle in the patients with multiple sclerosis allows us to objectify the existence of a right-left asymmetry, the behavior ankle-foot during the gait. At the same time this evolution is closely correlated with the contact surface that tends to increase, which means involving the reflex mechanisms that place the foot in the zone of minimum risk and assure the stability of the body.

摘要

背景

多发性硬化症患者可能会出现肌肉变化,这涉及到动力学和运动学参数的步态障碍,其步态在临床上可能是对称的或不对称的。

目的

本研究的目的是分析肌肉变化如何通过干扰运动控制来影响步态期间足部稳定性的生物力学参数。

方法

研究组由13名被诊断为多发性硬化症且临床上可检测到异常步态的患者组成。生物力学评估包括足部轴线和角度——内外旋转;足部与步态方向的角度偏差;距下关节角度。

结果

左脚的足部角度值在-10.74°至26.38°之间,右脚的足部角度值在-11.16°至30.04°之间。足部轴线角度是足部相对于步态方向的轴线,距下关节角度是相对于足部垂直轴线的角度。右脚在初始接触阶段旋前,随后在半支撑阶段旋后,在推进阶段回到中立位置,这意味着处于最小风险的自由区域。

结论

对多发性硬化症患者的足部角度和距下关节角度进行生物力学分析,使我们能够客观地确定左右不对称的存在,以及步态期间踝足的行为。同时,这种演变与趋于增加的接触面密切相关,这意味着涉及将足部置于最小风险区域并确保身体稳定性的反射机制。

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