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预期两倍干扰对健全步态的影响:躯干前屈和地面不平整。

The effects of an expected twofold perturbation on able-bodied gait: Trunk flexion and uneven ground surface.

机构信息

Department of Motion Science, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07740 Jena, Germany.

Department of Motion Science, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07740 Jena, Germany.

出版信息

Gait Posture. 2018 Mar;61:431-438. doi: 10.1016/j.gaitpost.2018.02.013. Epub 2018 Feb 17.

Abstract

BACKGROUND

Although alteration in trunk orientation and ground level potentially affects gait pattern individually, it is plausible to examine the interaction effects of such factors.

OBJECTIVE

The interaction effects between trunk-flexed gait and uneven ground on able-bodied gait pattern.

METHODS

For twelve able-bodied participants, we compared the adaptive mechanisms in kinematics, kinetics and spatial-temporal parameters of gait (STPG) with bent postures (30° and 50° of sagittal trunk flexion) across uneven surface (10-cm visible drop at the sight of the second ground contact) with that of upright posture on even ground surface.

RESULTS

Significant between-posture changes on the uneven surface included a decreased peak ankle dorsiflexion angle and vertical ground reaction force (GRF) 2nd peak as trunk flexion increased. Moreover, significant between-ground surface changes for each individual gait posture were a decreased peak ankle dorsiflexion angle and ankle range of motion irrespective of trunk posture and a reduced trailing step duration and vertical GRF 2nd peak in upright walking. The spatial parameters of gait remained unchanged across uneven surface, but at the expense of pronounced adjustments in temporal parameters, i.e., a more conservative gait strategy, indicating a distinct contribution from spatial and temporal strategies in trunk-flexed gaits. This was associated with greater peak flexion angles across lower limb joints regardless of trunk posture, alongside with an exertion of greater forces at faster rates earlier in stance and attenuated forces at lower rates at the end of the stance (i.e., early-skewed vertical GRF). When considering the main effect of posture, a more crouched gait was executed with reduced temporal parameters (except for cadence) and an early-skewed vertical GRF patterns with increasing trunk flexion.

SIGNIFICANCE

These results may have implications for understanding the nature of compensatory mechanisms in gait pattern of older adults and/or patients with altered trunk orientations while accommodating uneven ground.

摘要

背景

尽管躯干姿势和地面水平的改变可能会单独影响步态模式,但检查这些因素的相互作用效应是合理的。

目的

研究躯干弯曲步态和不平整地面对健全人步态模式的相互作用效应。

方法

我们比较了 12 名健康参与者在不平整地面(第二个地面接触点可见 10 厘米落差)上以弯曲姿势(矢状面躯干弯曲 30°和 50°)和在平整地面上以直立姿势时的运动学、动力学和时空参数(STPG)的适应性机制。

结果

在不平整表面上,随着躯干弯曲度的增加,显著的姿势间变化包括峰值踝关节背屈角度和垂直地面反作用力(GRF)第 2 峰值的降低。此外,对于每个个体步态姿势,在不平整表面上的显著地面间变化包括峰值踝关节背屈角度和踝关节运动范围的降低,无论躯干姿势如何,以及拖步行走阶段持续时间和垂直 GRF 第 2 峰值的减少。步态的空间参数在不平整表面上保持不变,但以时间参数的明显调整为代价,即更保守的步态策略,表明在躯干弯曲步态中空间和时间策略有明显的贡献。这与下肢关节的更大峰值弯曲角度有关,无论躯干姿势如何,以及在站立早期更快的速度下施加更大的力,在站立末期以更低的速度衰减力(即垂直 GRF 早期倾斜)。当考虑姿势的主要效应时,随着躯干弯曲度的增加,执行更蹲伏的步态,具有减少的时间参数(除了步频)和垂直 GRF 早期倾斜模式。

意义

这些结果可能对理解老年人和/或躯干姿势改变的患者在适应不平整地面时步态模式的补偿机制的性质具有意义。

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