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临床步行测试和惯性传感器 6 分钟步行测试中的步态模式特征:下肢截肢患者的随访。

Clinical Walking Tests and Gait Pattern Characterization During 6-Minute Walk Test Using Inertial Sensors: Follow-Up in Individuals With Lower Limb Amputation.

机构信息

Laval University.

Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS).

出版信息

J Appl Biomech. 2021 Oct 1;37(5):440-449. doi: 10.1123/jab.2020-0327. Epub 2021 Sep 9.

DOI:10.1123/jab.2020-0327
PMID:34504044
Abstract

Inertial measurement units and normative values enable clinicians to quantify clinical walking tests and set rehabilitation goals. Objectives of this study were (1) to compare time- and distance-based walking tests in individuals with lower limb amputation (iLLA) and normative values following rehabilitation discharge (T1) and 6 weeks after discharge (T2) and (2) to investigate spatiotemporal and foot kinematic parameters over a 6-minute walk test using inertial measurement units. Twelve iLLA participated in this study. Distance, cadence, stance ratio, loading rate ratio, push-up ratio, path length, and minimum toe clearance were analyzed during 6-minute walk test. Nonparametric repeated-measures analysis of variance tests, Bonferroni corrections, were performed. Time of distance-based walking tests diminished at T2 (P < .02). Compared with normative values, walking performance in iLLA was reduced. Cadence at T2 increased significantly (P = .026). Stance ratio increased in both legs at T2 (P < .05). Push-up ratio tended to decrease at T2 in the amputated leg (P = .0003). Variability of path length and minimum toe clearance at T2 were less than at T1 in the nonamputated leg (P < .05). Spatiotemporal improvement at T2 could be due to prosthesis adaptation in iLLA. The lower performance of the functional walk test compared with normative values could be due to amputation and pain-related fatigue.

摘要

惯性测量单元和正常值使临床医生能够量化临床步行测试并设定康复目标。本研究的目的是:(1)比较下肢截肢患者康复出院时(T1)和出院后 6 周(T2)的时间和距离为基础的步行测试与正常值,并(2)使用惯性测量单元研究 6 分钟步行测试中的时空和足部运动学参数。12 名下肢截肢患者参与了这项研究。在 6 分钟步行测试中分析了距离、步频、站立比、负重率比、蹬起比、路径长度和最小足趾间隙。采用非参数重复测量方差分析检验,进行 Bonferroni 校正。T2 时距离为基础的步行测试时间减少(P <.02)。与正常值相比,下肢截肢患者的步行表现降低。T2 时步频显著增加(P =.026)。T2 时双侧站立比均增加(P <.05)。T2 时假肢侧的蹬起比有下降趋势(P =.0003)。T2 时非截肢侧的路径长度和最小足趾间隙的变异性小于 T1(P <.05)。T2 时的时空改善可能是由于下肢截肢患者对假肢的适应。与正常值相比,功能步行测试的表现较低可能是由于截肢和与疼痛相关的疲劳。

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