Department of Health and Human Development, Western Washington University, Bellingham, WA, 98225, United States.
Gait Posture. 2020 Mar;77:112-117. doi: 10.1016/j.gaitpost.2020.01.023. Epub 2020 Jan 31.
Hallux valgus (HV) is a highly prevalent foot deformity in older women. Differences in lower extremity joint function of older women with and without HV during walking at slower and faster speeds are unknown.
Does walking speed affect lower extremity joint range of motion (ROM) and net extensor joint moment and associated work in older women with and without HV?
Thirteen older women with HV and 13 controls completed five walking trials at 1.1 and 1.3 m·s as kinematic marker position and ground reaction force data were collected. Net ankle, knee, and hip joint moments were computed using inverse dynamics during the stance phase. Positive joint work was calculated by integrating hip power in early stance, knee power in mid stance, and ankle power in late stance.
Average ankle ROM and plantarflexor moment did not increase with walking speed in the HV group, while in the control group these variables were greater for the faster compared to the slower speed (p < 0.05). The magnitude of increase in ankle joint work with speed was 12 % lesser in the HV compared to the control group (p = 0.008). The hip ROM, extensor moment, and associated work was greater in the HV compared to the control group (p < 0.05). Knee and hip joint ROM, extensor moments, and work increased with walking speed in both groups (p < 0.05).
Older women with HV compared to older women without HV demonstrate a distal-to-proximal redistribution by increasing hip motion and effort to compensate for reduced ankle contribution during walking.
拇外翻(HV)是老年女性中一种高发的足部畸形。在较慢和较快的行走速度下,患有和不患有 HV 的老年女性下肢关节功能的差异尚不清楚。
行走速度是否会影响患有和不患有 HV 的老年女性的下肢关节活动范围(ROM)和净伸肌关节力矩及其相关工作?
13 名患有 HV 的老年女性和 13 名对照者在 1.1 和 1.3 m·s 的速度下完成了 5 次行走试验,同时收集运动学标记位置和地面反力数据。在站立阶段使用逆动力学计算踝关节、膝关节和髋关节的净关节力矩。通过整合早期站立时的髋关节功率、中期站立时的膝关节功率和晚期站立时的踝关节功率来计算正关节功。
在 HV 组中,踝关节 ROM 和跖屈肌力矩并未随行走速度的增加而增加,而在对照组中,这些变量在较快速度下大于较慢速度(p < 0.05)。与对照组相比,HV 组踝关节关节功随速度增加的幅度小 12%(p = 0.008)。与对照组相比,HV 组的髋关节 ROM、伸肌力矩和相关工作更大(p < 0.05)。在两组中,膝关节和髋关节 ROM、伸肌力矩和功都随行走速度的增加而增加(p < 0.05)。
与不患有 HV 的老年女性相比,患有 HV 的老年女性在行走时通过增加髋关节运动和努力来补偿踝关节贡献的减少,表现出从远端到近端的重新分布。