步行速度对健康参与者步态生物力学的影响：系统评价和荟萃分析。

BACKGROUND: Understanding the effects of gait speed on biomechanical variables is fundamental for a proper evaluation of alterations in gait, since pathological individuals tend to walk slower than healthy controls. Therefore, the aim of the study was to perform a systematic review of the effects of gait speed on spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces in healthy children, young adults, and older adults. METHODS: A systematic electronic search was performed on PubMed, Embase, and Web of Science databases to identify studies published between 1980 and 2019. A modified Quality Index was applied to assess methodological quality, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences. For the meta-analyses, a fixed or random effect model and the statistical heterogeneity were calculated using the I index. RESULTS: Twenty original full-length studies were included in the final analyses with a total of 587 healthy individuals evaluated, of which four studies analyzed the gait pattern of 227 children, 16 studies of 310 young adults, and three studies of 59 older adults. In general, gait speed affected the amplitude of spatiotemporal gait parameters, joint kinematics, joint kinetics, and ground reaction forces with a decrease at slow speeds and increase at fast speeds in relation to the comfortable speed. Specifically, moderate-to-large effect sizes were found for each age group and speed: children (slow, - 3.61 to 0.59; fast, - 1.05 to 2.97), young adults (slow, - 3.56 to 4.06; fast, - 4.28 to 4.38), and older adults (slow, - 1.76 to 0.52; fast, - 0.29 to 1.43). CONCLUSIONS: This review identified that speed affected the gait patterns of different populations with respect to the amplitude of spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces. Specifically, most of the values analyzed decreased at slower speeds and increased at faster speeds. Therefore, the effects of speed on gait patterns should also be considered when comparing the gait analysis of pathological individuals with normal or control ones.

背景：了解步态速度对生物力学变量的影响对于正确评估步态变化至关重要，因为病理个体往往比健康对照者走得慢。因此，本研究旨在对健康儿童、青年人和老年人的步态速度对时空参数、关节运动学、关节动力学和地面反力的影响进行系统综述。

方法：在 PubMed、Embase 和 Web of Science 数据库中进行了系统的电子检索，以确定 1980 年至 2019 年期间发表的研究。应用改良的质量指数评估方法学质量，并计算效应量及其 95%置信区间作为标准化均数差。对于荟萃分析，使用 I 指数计算固定或随机效应模型和统计异质性。

结果：最终分析纳入了 20 项原始全文研究，共评估了 587 名健康个体，其中 4 项研究分析了 227 名儿童的步态模式，16 项研究分析了 310 名青年人和 3 项研究分析了 59 名老年人。一般来说，步态速度影响时空步态参数、关节运动学、关节动力学和地面反力的幅度，在较慢速度下减小，在较快速度下增加，与舒适速度有关。具体而言，每个年龄组和速度都发现了中等至较大的效应量：儿童（慢，-3.61 至 0.59；快，-1.05 至 2.97）、青年人（慢，-3.56 至 4.06；快，-4.28 至 4.38）和老年人（慢，-1.76 至 0.52；快，-0.29 至 1.43）。

结论：本综述确定速度影响了不同人群的步态模式，具体表现为时空参数、关节运动学、关节动力学和地面反力的幅度。具体来说，大多数分析值在较慢速度下减小，在较快速度下增加。因此，在比较病理个体与正常或对照者的步态分析时，也应考虑速度对步态模式的影响。