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二维步态分析在痉挛性四肢瘫患者步态障碍评估中的应用。

Application of 2D Gait Analysis for the Assessment of Gait Disturbance in Patients with Spastic Tetraparesis.

机构信息

Assistant, Kolokoltsev Department of Traumatology, Orthopedics and Neurosurgery Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.

Student Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.

出版信息

Sovrem Tekhnologii Med. 2021;13(5):24-29. doi: 10.17691/stm2021.13.5.03. Epub 2021 Oct 29.

Abstract

UNLABELLED

was to explore the use of 2D gait analysis for assessing gait abnormalities in patients with spastic tetraparesis associated with spinal cord injury and other lesions of the cervical spinal cord.

MATERIALS AND METHODS

The study included 12 patients with tetraparesis of various etiologies. Gait assessment was performed by video analysis using reflective markers (1.5 cm) and a special walking platform. The spatial coordinates of the markers were determined by capturing the reflected light with infrared LEDs located around the lenses of video cameras.

RESULTS

Using 2D gait analysis, numerical indicators of gait disturbance in spastic tetraparesis were obtained. We found a prolongation of the stand phase with a shortening of the swing phase (from 81.9 [76.1; 89.2] to 85.3 [74.4; 90.2]%; p=0.97) and the period of the double step (from 0.50 [0.45; 0.96] to 0.40 [0.34; 0.66]; p=0.4) in comparison with the target (normal) values (60% - for the stand phase; 1.41 - for the double-step period). The movements in the hip, knee, and ankle joints are described using numerical values.We then compared the data obtained from the left and right sides of the patient's body: there were no statistically significant differences between the two sets of data. We also compared the gait characteristics before and after treatment (in 4 patients). Statistically significant differences in values were obtained for the stand and swing phases (p=0.035), the range of motion in the hip joint (p=0.01), and gait velocity (p=0.046). Kendall's analysis revealed no significant correlation between the data obtained by video gait analysis and the gait changes by the Modified Ashworth Scale (р>0.05).

CONCLUSION

2D gait analysis is a promising method for quantifying gait disturbance in patients with spastic tetraparesis. It allows one to identify characteristic gait patterns, in particular, an increase in the stand phase with a shortening of the swing phase and the double step period, as well as a decrease in the range of motion in the hip joints with an increase in the knee and ankle ones.

摘要

目的

探索使用二维步态分析评估脊髓损伤和其他颈椎脊髓病变引起的痉挛性四肢瘫痪患者的步态异常。

材料与方法

研究纳入了 12 名不同病因的四肢瘫痪患者。步态评估采用视频分析,使用反射标记物(1.5cm)和特殊的步行平台进行。标记物的空间坐标通过捕获位于摄像机镜头周围的红外 LED 反射光来确定。

结果

通过二维步态分析,获得了痉挛性四肢瘫痪步态障碍的数值指标。我们发现站立相延长,摆动相缩短(从 81.9%[76.1%;89.2%]变为 85.3%[74.4%;90.2%];p=0.97),双步周期延长(从 0.50[0.45;0.96]变为 0.40[0.34;0.66];p=0.4),与目标(正常)值相比。髋关节、膝关节和踝关节的运动用数值表示。然后,我们比较了患者身体左右两侧的数据:两组数据之间没有统计学差异。我们还比较了治疗前后(4 名患者)的步态特征。站立相和摆动相(p=0.035)、髋关节活动度(p=0.01)和步态速度(p=0.046)的数值有统计学差异。Kendall 分析显示,视频步态分析和改良 Ashworth 量表评估的步态变化之间无显著相关性(p>0.05)。

结论

二维步态分析是量化痉挛性四肢瘫痪患者步态障碍的一种很有前途的方法。它可以识别出特征性的步态模式,特别是站立相延长,摆动相缩短,双步周期延长,髋关节活动度减小,膝关节和踝关节活动度增大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f841/8858409/f3e68e27e9ce/STM-13-5-03-f1.jpg

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