Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Potchefstroom Campus, North-West University (NWU), Potchefstroom, South Africa; Université Côte d'Azur, LAMHESS, France; Laboratory of Physiology and Biomechanics of Locomotion, Institute of Neuroscience (IoNS), Université catholique de Louvain (UCL), Louvain-la-Neuve, Belgium.
Université Côte d'Azur, LAMHESS, France; Centre de Santé Institut Rossetti-PEP06, Nice, France.
Clin Biomech (Bristol). 2023 Feb;102:105899. doi: 10.1016/j.clinbiomech.2023.105899. Epub 2023 Jan 31.
Facioscapulohumeral dystrophy is a genetic disease characterized by progressive muscle weakness leading to a complex combination of postural instability, foot drop during swing and compensatory strategies during gait that have been related to an increased risk of falling. The aim is to assess the effect of tibialis anterior muscle weakness on foot drop and minimum toe clearance of patients with facioscapulohumeral dystrophy during gait.
Eight patients allocated to a subgroup depending on the severity of tibialis anterior muscle weakness, assessed by manual muscle testing (i.e., severe and mild weakness), and eight matched control participants underwent gait analysis at self-selected walking speeds.
Walking speed, for all facioscapulohumeral dystrophy patients, and step length, for patients with severe weakness only, were significantly decreased compared to control participants. Minimum toe clearance was similar across all groups, but its variability was increased only for patients with severe weakness. A greater foot drop was systematically observed for patients with severe weakness during swing and only in late swing for patients with mild weakness. Individual strategies to compensate for foot drop remain unclear and may depend on other muscle impairment variability.
Although all patients were able to control the average height of their foot trajectory during swing, patients with severe tibialis anterior muscle weakness exhibited increased foot drop and minimum toe clearance variability. Manual muscle testing is a simple, cheap and effective method to assess tibialis anterior muscle weakness and seems promising to identify facioscapulohumeral dystrophy patients with an increased risk of tripping.
面肩肱型肌营养不良症是一种遗传性疾病，其特征是进行性肌肉无力，导致姿势不稳定、摆动时足下垂以及步态中代偿策略的复杂组合，这些都与跌倒风险增加有关。目的是评估胫骨前肌无力对面肩肱型肌营养不良症患者步态中足下垂和最小脚趾离地间隙的影响。
根据手动肌肉测试评估的胫骨前肌无力严重程度（即严重和轻度无力），将 8 名患者分为亚组，并将 8 名匹配的对照参与者纳入步态分析，在自我选择的行走速度下进行。
与对照组相比，所有面肩肱型肌营养不良症患者的行走速度以及仅严重无力患者的步长均显著降低。最小脚趾离地间隙在所有组中相似，但仅严重无力患者的变异性增加。严重无力患者在摆动期观察到更明显的足下垂，而轻度无力患者仅在晚期摆动期观察到足下垂。严重无力患者的代偿策略仍不清楚，可能取决于其他肌肉损伤的变异性。
尽管所有患者都能够控制摆动期间其足部轨迹的平均高度，但严重胫骨前肌无力的患者表现出更大的足下垂和最小脚趾离地间隙变异性。手动肌肉测试是评估胫骨前肌无力的一种简单、廉价且有效的方法，似乎有望识别出跌倒风险增加的面肩肱型肌营养不良症患者。
