Müßig Janina A, Brauner Torsten, Kröger Inga, Varady Patrick A, Brand Andreas, Klöpfer-Krämer Isabella, Simmel Stefan, Horstmann Thomas, Augat Peter
Institute for Biomechanics.
Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich.
Int J Rehabil Res. 2019 Jun;42(2):139-144. doi: 10.1097/MRR.0000000000000337.
Gait variability is often associated with reduced coordination and increased instability during walking. Especially for patients with musculoskeletal conditions, variability in gait might be associated with the level of daily activity. Therefore, this study examines kinematic variability during walking and the association with daily activity in patients with transfemoral amputation. Therefore, 15 transfemoral amputees, using the C-leg prosthesis of Otto Bock, between 18 and 65 years were recruited during their hospital stay. All patients were able to walk without crutches in everyday life and were familiar with walking using the C-leg system. Gait parameters and data of variability were captured during walking in a gait laboratory by eight infrared cameras (Vicon). Daily activity was assessed using a three-dimensional acceleration sensor of VitaMove. Patients showed variability from 0.84° up to 1.96° in frontal pelvis motion and from 0.9° up to 4.02° in trunk obliquity. The results show a significant correlation between activity and variability in trunk (r = -0.58; P ≤ 0.05) and pelvis (r = -0.63; P ≤ 0.01) as well as gait velocity (r = 0.6; P ≤ 0.05). However, kinematic variability and gait velocity are not related to each other. In conclusion, the results show that kinematic gait variability is associated with the extent of activity and therefore presents an important parameter for assessing amputees' gait quality and daily activity.
步态变异性通常与行走过程中协调性降低和不稳定性增加相关。特别是对于患有肌肉骨骼疾病的患者，步态变异性可能与日常活动水平有关。因此，本研究考察了经股截肢患者行走过程中的运动学变异性及其与日常活动的关联。为此，在15名年龄在18至65岁之间、使用奥托博克C型假肢的经股截肢患者住院期间招募了他们。所有患者在日常生活中都能够不用拐杖行走，并且熟悉使用C型腿系统行走。在步态实验室中，通过八个红外摄像机（Vicon）在患者行走过程中采集步态参数和变异性数据。使用VitaMove的三维加速度传感器评估日常活动。患者的骨盆前向运动变异性为0.84°至1.96°，躯干倾斜变异性为0.9°至4.02°。结果显示，活动与躯干（r = -0.58；P ≤ 0.05）和骨盆（r = -0.63；P ≤ 0.01）的变异性以及步态速度（r = 0.6；P ≤ 0.05）之间存在显著相关性。然而，运动学变异性和步态速度彼此无关。总之，结果表明运动学步态变异性与活动程度相关，因此是评估截肢者步态质量和日常活动的一个重要参数。
