Nazary-Moghadam Salman, Salavati Mahyar, Esteki Ali, Akhbari Behnam, Keyhani Sohrab, Zeinalzadeh Afsaneh
Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Knee. 2019 Jan;26(1):88-96. doi: 10.1016/j.knee.2018.11.009. Epub 2018 Nov 22.
Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion-extension variability in subjects with and without ACL deficiency.
The knee flexion-extension Lyapunov exponent (LyE) was measured in 22 ACL-deficient (Mean±SD) (25.95 ± 4.69 years) and 22 healthy subjects (24.18 ± 3.32 years). They walked at three levels of gait speed in isolation or concurrently with a cognitive task.
Repeated-measure analyses of variance (ANOVAs) demonstrated that the interaction of group by gait speed was statistically significant. As the gait speed increased from low to high, the knee flexion-extension LyE significantly decreased for the subjects with ACL deficiency (effect size: 0.57, P = 0.01). The interaction of group by cognitive load was not statistically significant (P = 0.07). In addition, the ACL-deficient subjects had statistically slower reaction times than healthy subjects during the dual-task compared with the single-task condition.
The ACL-deficient and healthy individuals had a tendency to maintain safe gait. It seems that the ACL-deficient subjects sacrificed the cognitive task more than the healthy individuals to pay more attention toward gait. Additionally, it seems that the gait speed was more challenging than cognitive load on the stride-to-stride variability in the individuals with ACL deficiency.
多项研究探讨了前交叉韧带(ACL)损伤个体的步态变异性;然而,多任务处理对这些个体步态变异性的影响仍不明确。本研究的目的是确定步态速度和多任务处理对有或无前交叉韧带损伤受试者膝关节屈伸变异性的影响。
对22名ACL损伤患者(平均±标准差)(25.95±4.69岁)和22名健康受试者(24.18±3.32岁)测量膝关节屈伸李雅普诺夫指数(LyE)。他们在三种步态速度水平下单独行走或同时进行认知任务。
重复测量方差分析(ANOVA)表明,组与步态速度的交互作用具有统计学意义。随着步态速度从低到高增加,ACL损伤受试者的膝关节屈伸LyE显著降低(效应量:0.57,P = 0.01)。组与认知负荷的交互作用无统计学意义(P = 0.07)。此外,与单任务条件相比,ACL损伤受试者在双任务期间的反应时间在统计学上比健康受试者慢。
ACL损伤和健康个体都倾向于保持安全步态。似乎ACL损伤受试者比健康个体更多地牺牲认知任务以更关注步态。此外,对于ACL损伤个体,步态速度似乎比认知负荷对步幅间变异性更具挑战性。