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唐氏综合征患者的男性和女性表现出不同的运动学(但不是时空)步态模式。

Men and women with Down syndrome exhibit different kinematic (but not spatio-temporal) gait patterns.

机构信息

Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.

Department of Rehabilitation of Pediatrics and Developmental Disabilities, IRCCS San Raffaele Pisana, Rome, Italy.

出版信息

J Intellect Disabil Res. 2019 Jan;63(1):64-71. doi: 10.1111/jir.12560. Epub 2018 Oct 29.

Abstract

BACKGROUND

Gait phenotypes are well documented in people with Down syndrome (pwDS), but sex-related differences are still unexplored. This study investigated the existence of possible differences in spatio-temporal and kinematic parameters of gait between men and women with DS using quantitative three-dimensional gait analysis.

METHODS

Gait patterns of 117 pwDS (53 F, 64 M) who underwent a computerised gait analysis from 2002 to 2017 were retrospectively analysed to obtain spatio-temporal gait parameters and kinematics in the sagittal plane at hip, knee and ankle joints, as well as foot progression.

RESULTS

Overall, when considered as a single group, the gait patterns found for pwDS confirmed the findings of previous studies. However, when analysed by sex, our data revealed that women with DS exhibit a larger hip flexion at late stance (42% to 54% of the gait cycle) and reduced knee flexion at the beginning of the swing phase (61% to 69% of the gait cycle). In contrast, men are characterised by larger foot extra-rotation angles through most of the stance phase (from 0% to 55% of the gait cycle) and at the end of the swing phase (92% to 99% of the gait cycle). No differences between men and women with DS were found concerning ankle dorsi- plantar-flexion or in all spatio-temporal parameters normalised by individuals' anthropometry, excluding cadence (higher in women).

CONCLUSIONS

The findings of the present study highlight the need to investigate gait dysfunctions in pwDS by taking their sex into consideration. Such an approach may be useful not only in gaining a better understanding of the pathophysiology of gait disturbances associated with DS but also in supporting a better orientation of rehabilitative treatments.

摘要

背景

唐氏综合征(DS)患者的步态表型已有大量文献记载,但性别相关差异仍未得到探索。本研究采用定量三维步态分析,研究了男性和女性 DS 患者在步态时空和运动学参数方面是否存在差异。

方法

回顾性分析了 2002 年至 2017 年间接受计算机步态分析的 117 名 DS 患者(53 名女性,64 名男性)的步态模式,以获得髋关节、膝关节和踝关节矢状面的时空步态参数和运动学参数,以及足廓清。

结果

总体而言,当将 DS 患者视为一个单一的群体时,发现的步态模式证实了先前研究的发现。然而,按性别分析时,我们的数据显示,DS 女性在晚期站立时髋关节屈曲度较大(步态周期的 42%至 54%),在摆动期开始时膝关节屈曲度较小(步态周期的 61%至 69%)。相比之下,男性的特征是在大部分站立期(步态周期的 0%至 55%)和摆动期结束时(步态周期的 92%至 99%)足部外旋角度较大。DS 男性和女性在踝关节背屈-跖屈或所有通过个体人体测量学标准化的时空参数方面没有差异,除了步频(女性较高)。

结论

本研究的结果强调了在考虑 DS 患者性别的情况下,需要研究步态障碍。这种方法不仅有助于更好地理解与 DS 相关的步态障碍的病理生理学,而且有助于更好地指导康复治疗。

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