Mirando Marta, Conti Corrado, Zeni Federica, Pedicini Fabio, Nardone Antonio, Pavese Chiara
Centro Studi Attività Motorie of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Diagnostics (Basel). 2022 Jan 14;12(1):199. doi: 10.3390/diagnostics12010199.
(1) Background: Ankle fracture results in pain, swelling, stiffness and strength reduction, leading to an altered biomechanical behavior of the joint during the gait cycle. Nevertheless, a common pattern of kinematic alterations has still not been defined. To this end, we analyzed the literature on instrumental gait assessment after ankle fracture, and its correlation with evaluator-based and patient-reported outcome measures. (2) Methods: We conducted a systematic search, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, of articles published from January 2000 to June 2021 in PubMed, Embase and PEDro on instrumental gait assessment after ankle fracture. (3) Results: Several changes in gait occur after ankle fracture, including a reduction in step length, swing time, single support time, stride length, cadence, speed and an earlier foot-off time in the affected side. Additionally, trunk movement symmetry (especially vertical) is significantly reduced after ankle fracture. The instrumental assessments correlate with different clinical outcome measures. (4) Conclusions: Instrumental gait assessment can provide an objective characterization of the gait alterations after ankle fracture. Such assessment is important not only in clinical practice to assess patients' performance but also in clinical research as a reference point to evaluate existing or new rehabilitative interventions.
（1）背景：踝关节骨折会导致疼痛、肿胀、僵硬和力量减弱，从而在步态周期中改变关节的生物力学行为。然而，运动学改变的常见模式仍未明确。为此，我们分析了有关踝关节骨折后仪器化步态评估的文献，以及它与基于评估者和患者报告的结果测量之间的相关性。（2）方法：我们按照系统评价和Meta分析的首选报告项目指南，对2000年1月至2021年6月在PubMed、Embase和PEDro上发表的关于踝关节骨折后仪器化步态评估的文章进行了系统检索。（3）结果：踝关节骨折后会出现多种步态变化，包括患侧步长、摆动时间、单支撑时间、步幅、步频、速度降低以及更早的离地时间。此外，踝关节骨折后躯干运动对称性（尤其是垂直方向）显著降低。仪器化评估与不同的临床结果测量相关。（4）结论：仪器化步态评估可以客观地描述踝关节骨折后的步态改变。这种评估不仅在临床实践中对于评估患者的表现很重要，而且在临床研究中作为评估现有或新的康复干预措施的参考点也很重要。
