Dewar Cuyler, Grindstaff Terry L, Farmer Brooke, Sainsbury Morgan, Gay Sam, Kroes Weston, Martin Kevin D
School of Medicine, Creighton University, Omaha, NE, USA.
Department of Physical Therapy, Creighton University, Omaha, NE, USA.
Foot Ankle Orthop. 2021 Dec 8;6(4):24730114211060054. doi: 10.1177/24730114211060054. eCollection 2021 Oct.
Foot and ankle injuries frequently require a period of nonweightbearing, resulting in muscle atrophy. Our previous study compared a hands-free single crutch (HFSC) to standard axillary crutches and found increased muscle recruitment and intensity while using the HFSC. Knee scooters are another commonly prescribed nonweightbearing device. The purpose of this study is to examine the electromyographic (EMG) differences between an HFSC and knee scooter, in conjunction with device preference and perceived exertion.
A randomized crossover study was performed using 30 noninjured young adults. Wireless surface EMG electrodes were placed on the belly of the rectus femoris (RF), vastus lateralis (VL), lateral gastrocnemius (LG), and gluteus maximus (GM). Participants then ambulated along a 20-m walking area while 15 seconds of the gait cycle was recorded across 3 conditions: walking with a knee scooter, an HFSC, and with no assistive device. Mean muscle activity and peak EMG activity were recorded for each ambulatory modality. Immediately following testing, patient exertion and device preference was recorded.
The RF, LG, and GM showed increased peak EMG activity percentage, and the LG showed increased mean muscle activity while using the HFSC compared with the knee scooter. When comparing the knee scooter and HFSC to walking, both showed increased muscle activity in the RF, VL, and LG but no difference in the GM. There was no statistical difference in participant preference, whereas the HFSC had a statistically significant higher perceived exertion than the knee scooter ( < .001).
In this group of young, healthy noninjured volunteers, the HFSC demonstrated increased peak EMG activity in most muscle groups tested compared with the knee scooter.
Level II, prospective comparative study.
足踝部损伤常常需要一段时间的非负重期，这会导致肌肉萎缩。我们之前的研究比较了免手持单拐（HFSC）与标准腋拐，发现使用HFSC时肌肉募集增加且强度更大。膝行器是另一种常用的非负重辅助器械。本研究的目的是探讨HFSC与膝行器之间的肌电图（EMG）差异，以及器械偏好和主观用力程度。
对30名未受伤的年轻成年人进行了一项随机交叉研究。将无线表面肌电电极置于股直肌（RF）、股外侧肌（VL）、腓外侧肌（LG）和臀大肌（GM）肌腹上。然后，参与者在20米的步行区域行走，同时记录3种情况下步态周期的15秒数据：使用膝行器行走、使用HFSC行走以及不使用辅助器械行走。记录每种行走方式下的平均肌肉活动和肌电峰值活动。测试结束后，立即记录患者的用力程度和器械偏好。
与膝行器相比，使用HFSC时，RF、LG和GM的肌电峰值活动百分比增加，LG的平均肌肉活动增加。将膝行器和HFSC与步行进行比较时，两者在RF、VL和LG中的肌肉活动均增加，但GM无差异。参与者的偏好没有统计学差异，而HFSC的主观用力程度在统计学上显著高于膝行器（P<0.001）。
在这组年轻、健康的未受伤志愿者中，与膝行器相比，HFSC在大多数测试肌肉群中表现出更高的肌电峰值活动。
II级，前瞻性比较研究。
