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肩部在不同位置固定是否会影响步态?

Does immobilization of the shoulder in different positions affect gait?

机构信息

Hedef Physiotherapy Centre, Balıkesir, Turkey.

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

出版信息

Gait Posture. 2022 Jan;91:254-259. doi: 10.1016/j.gaitpost.2021.10.018. Epub 2021 Oct 25.

DOI:10.1016/j.gaitpost.2021.10.018
PMID:34775228
Abstract

BACKGROUND

The shoulder joint is immobilized in various positions after injury or reconstructive operative intervention. It is not clear how these immobilization positions in the shoulder joint affect gait.

RESEARCH QUESTION

Does the immobilized shoulder joint in different positions following shoulder surgery or injury affect gait?

METHODS

A total of 38 healthy individuals with a mean age of 25.94 years and BMI of 25.66 kg/m, underwent gait analysis in 4 different immobilized positions and normal gait. Gait parameters were evaluated using the GAITRite electronic walkway, and to determine symmetry, the bilateral spatiotemporal gait parameters were calculated using the Symmetry Index. Repeated-measures one way analysis of variance was used to compare the walking parameters in different positions.

RESULTS

Velocity, step length and stride length were significantly decreased, and step width and single support time were increased in some immobilized positions (p < 0.05). Differences in asymmetry were determined in the gait parameters of the immobilized positions but not significantly. When the shoulder was immobilized in abduction, step width asymmetry tended to increase but it was not significant.

SIGNIFICANCE

This cross-sectional simulation study may be important in demonstrating the clinical changes of gait in injuries, pathologies, and postoperative rehabilitation that require the immobilization of the shoulder joint. It could be recommended that arm swing is included in gait rehabilitation, gait and balance training can be provided to patients after shoulder immobilization.

摘要

背景

肩部在受伤或重建手术后会以各种姿势固定。目前尚不清楚这些肩关节固定姿势对步态有何影响。

研究问题

肩部手术后或受伤后不同固定位置是否会影响步态?

方法

共有 38 名健康个体参与研究,平均年龄 25.94 岁,BMI 为 25.66kg/m²。他们在 4 种不同的肩关节固定位置和正常步态下进行步态分析。使用 GAITRite 电子步态分析系统评估步态参数,使用对称性指数计算双侧时空步态参数以确定对称性。采用重复测量单向方差分析比较不同位置的行走参数。

结果

在某些固定位置,速度、步长和跨步长度显著降低,步宽和单支撑时间增加(p<0.05)。在固定位置的步态参数中确定了不对称性差异,但无统计学意义。当肩部外展固定时,步宽不对称性有增加的趋势,但无统计学意义。

意义

这项横断面模拟研究可能有助于展示需要肩关节固定的损伤、病理和术后康复中步态的临床变化。建议在肩关节固定后的步态康复中加入手臂摆动,为患者提供步态和平衡训练。

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