Gaffney Brecca M M, Christiansen Cory L, Murray Amanda M, Davidson Bradley S
University of Denver, Human Dynamics Laboratory, Denver, CO, United States.
University of Colorado Denver, Dept. of Physical Medicine & Rehabilitation, Aurora, CO, United States; VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO, United States.
J Electromyogr Kinesiol. 2018 Apr;39:16-25. doi: 10.1016/j.jelekin.2018.01.002. Epub 2018 Feb 3.
The objective of this investigation was to identify demands from core muscles that corresponded with trunk movement compensations during bilateral step ambulation in people with unilateral transtibial amputation (TTA). Trunk rotational angular momentum (RAM) was measured using motion capture and bilateral surface EMG was measured from four bilateral core muscles during step ascent and descent tasks in people with TTA and healthy controls. During step ascent, the TTA group generated larger mediolateral (P = 0.01) and axial (P = 0.01) trunk RAM toward the leading limb when stepping onto the intact limb than the control group, which corresponded with high demand from the bilateral erector spinae and oblique muscles. During step descent, the TTA group generated larger trunk RAM in the sagittal (P < 0.01), frontal (P < 0.01), and transverse planes (P = 0.01) than the control group, which was an effect of falling onto the intact limb. To maintain balance and arrest trunk RAM, core muscle demand was larger throughout the loading period of step descent in the TTA group. However, asymmetric trunk movement compensations did not correspond to asymmetric core muscle demand during either task, indicating a difference in motor control compensations dependent on the leading limb.
本研究的目的是确定单侧胫骨截肢（TTA）患者双侧步行动走过程中与躯干运动代偿相对应的核心肌肉需求。使用运动捕捉测量躯干旋转角动量（RAM），并在TTA患者和健康对照者的上台阶和下台阶任务中，从四块双侧核心肌肉测量双侧表面肌电图。在上台阶过程中，与对照组相比，TTA组在踏上健侧肢体时，向领先肢体产生更大的内外侧（P = 0.01）和轴向（P = 0.01）躯干RAM，这与双侧竖脊肌和斜肌的高需求相对应。在下台阶过程中，TTA组在矢状面（P < 0.01）、额状面（P < 0.01）和横断面（P = 0.01）产生的躯干RAM比对照组更大，这是由于落在健侧肢体上的影响。为了保持平衡并阻止躯干RAM，TTA组在下台阶的整个负重期核心肌肉需求更大。然而，在任何一项任务中，不对称的躯干运动代偿与不对称的核心肌肉需求均不对应，这表明运动控制代偿存在差异，且取决于领先肢体。
