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糖尿病周围神经病变患者在虚拟障碍物穿越任务中时空步态调整的改变。

An altered spatiotemporal gait adjustment during a virtual obstacle crossing task in patients with diabetic peripheral neuropathy.

机构信息

Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center (UNMC), Omaha, NE, United States of America.

Division of Diabetes, Endocrine and Metabolism, College of Medicine, UNMC, United States of America.

出版信息

J Diabetes Complications. 2019 Feb;33(2):182-188. doi: 10.1016/j.jdiacomp.2018.10.005. Epub 2018 Oct 17.

Abstract

This study investigates spatiotemporal gait adjustments that occur while stepping over virtual obstacles during treadmill walking in people with/without diabetic peripheral neuropathy (DPN). Eleven adults with Type 2 diabetes mellitus, ten DPN, and 11 age-matched healthy adults (HTY) participated in this study. They stepped over forthcoming virtual obstacles during treadmill walking. Outcomes such as success rate, spatiotemporal gait characteristics during obstacle crossing, and correlations between these variables were evaluated. The results partially supported our hypotheses that when comparing with HTY and DM, people with DPN adopted a crossing strategy which decreased obstacle crossing success rate and maximal toe elevation, and increased stride time and stance time during virtual obstacle crossing. This might be due to the compromised somatosensory functions of their lower extremity which may increase the risk of falling. This study also found an inter-leg relationship which may be applied to future stepping or obstacle crossing training that incorporates both legs as a means for improving outcomes of the trailing leg during daily obstacle negotiation.

摘要

本研究调查了在跑步机上行走时越过虚拟障碍物时发生的时空步态调整,参与者包括有/无糖尿病周围神经病变(DPN)的人群。11 名 2 型糖尿病患者、10 名 DPN 患者和 11 名年龄匹配的健康成年人(HTY)参加了这项研究。他们在跑步机上行走时越过即将到来的虚拟障碍物。评估了成功率、障碍物穿越过程中的时空步态特征以及这些变量之间的相关性等结果。结果部分支持了我们的假设,与 HTY 和 DM 相比,患有 DPN 的人采用了一种穿越策略,降低了障碍物穿越的成功率和最大脚趾抬高高度,增加了跨越虚拟障碍物时的步幅时间和站立时间。这可能是由于他们下肢的感觉功能受损,这可能会增加跌倒的风险。本研究还发现了一种腿间关系,可应用于未来的跨步或障碍物穿越训练,将双腿作为一种手段,提高在日常障碍物协商中尾随腿的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdf/6331236/8e32c7dce035/nihms-1512360-f0001.jpg

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