Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria; Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany.
Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany.
Hum Mov Sci. 2019 Dec;68:102539. doi: 10.1016/j.humov.2019.102539. Epub 2019 Nov 1.
Gait variability is a measure of gait disturbance, and therefore constitutes a useful parameter for gait assessment as well as planning of therapeutic and medical interventions. To date, variability during walking has not been adequately analyzed in amputees. The aim of this examination was to evaluate trunk and pelvic movement variability in transfemoral amputees. The effect of different types of walking surfaces on variability in trunk and pelvic movement was also studied.
This prospective clinical examination compares 20 transfemoral amputees (17 ♂, 42 ± 16 years; 3 ♀, 48 ± 3 years) with a group of 20 age and mass matched healthy controls regarding the extent of variability in trunk and pelvic movement. Kinematic data of trunk and pelvic movement during walking on level, uneven ground and slope was captured by eight infrared cameras (Vicon Nexus ™, Oxford, UK). Variability in trunk and pelvic movement was analyzed. Univariate ANCOVA and ANOVA with repeated measures and post hoc tests were used for statistical comparison. Fall history was retrospectively collected from medical history to assess the association between falls and variability in trunk and pelvic movement.
Trunk and pelvic movement variability in amputees was significantly higher during walking on uneven ground and slope compared to healthy controls (p ≤ 0.05). Variability in trunk and pelvic movement was increased during walking on uneven ground and slope compared to even ground for both groups (p ≤ 0.05).
Amputees showed increased trunk and pelvic movement variability during walking on uneven ground and slope, indicating an affected gait pattern in comparison to healthy controls. Therefore, trunk and pelvic movement variability could be a potential marker for gait quality with diagnostic implications.
步态变异性是步态障碍的一种衡量标准，因此它是步态评估以及治疗和医学干预计划的有用参数。迄今为止，假肢患者的行走过程中的变异性尚未得到充分分析。本研究旨在评估股骨截肢患者的躯干和骨盆运动变异性。还研究了不同类型的行走表面对躯干和骨盆运动变异性的影响。
本前瞻性临床研究比较了 20 名股骨截肢患者（17 名男性，42±16 岁；3 名女性，48±3 岁）和 20 名年龄和体重匹配的健康对照组在躯干和骨盆运动变异性方面的差异。使用 8 个红外摄像机（Vicon Nexus ™，牛津，英国）记录水平、不平坦地面和斜坡上行走时的躯干和骨盆运动的运动学数据。分析躯干和骨盆运动的变异性。使用单变量协方差分析和重复测量的方差分析以及事后检验进行统计比较。从病历中回顾性收集跌倒史，以评估躯干和骨盆运动变异性与跌倒之间的关联。
与健康对照组相比，截肢患者在不平坦地面和斜坡上行走时的躯干和骨盆运动变异性明显更高（p≤0.05）。两组在不平坦地面和斜坡上行走时的躯干和骨盆运动变异性均高于平坦地面（p≤0.05）。
与健康对照组相比，截肢患者在不平坦地面和斜坡上行走时躯干和骨盆运动变异性增加，表明其步态模式受到影响。因此，躯干和骨盆运动变异性可能是具有诊断意义的步态质量的潜在标志物。
