Chiou-Tan Faye Y, Bloodworth Donna
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.
Harris Health System, Electrodiagnostic Laboratory, Smith Clinic/Ben Taub Hospital, Houston, Texas, USA.
Muscle Nerve. 2025 May;71(5):857-868. doi: 10.1002/mus.28208. Epub 2024 Aug 6.
In order to understand abnormal gait, this article will first review normal gait, discuss how neuromuscular diseases disturb gait patterns and review orthotic interventions. In normal gait, concentric contractions accelerate and eccentric contractions decelerate the limb. Neuromuscular gait disorders can be grouped into (1) proximal weakness, (2) distal weakness, (3) nonlength-dependent or generalized weakness, (4) asymmetric weakness, and (5) sensory disorders. Identification of gait disturbance type in neuromuscular diseases leads to the appropriate orthotic prescription since orthotic strategies are grouped into (1) proximal weakness, (2) distal weakness, and (3) sensory disturbances. Orthotics is not indicated in all types of gait disturbance. Weakness in proximal hip musculature can be managed with gait aids such as walkers. In contrast, distal muscle weakness can be managed with orthotics. Preservation of gait assists in maintenance of daily function and integration in society.
为了理解异常步态，本文将首先回顾正常步态，讨论神经肌肉疾病如何干扰步态模式，并回顾矫形器干预措施。在正常步态中，向心收缩使肢体加速，离心收缩使肢体减速。神经肌肉性步态障碍可分为：（1）近端肌无力，（2）远端肌无力，（3）非长度依赖性或全身性肌无力，（4）不对称肌无力，以及（5）感觉障碍。确定神经肌肉疾病中的步态障碍类型可得出适当的矫形器处方，因为矫形器策略分为：（1）近端肌无力，（2）远端肌无力，以及（3）感觉障碍。并非所有类型的步态障碍都需要使用矫形器。近端髋部肌肉的无力可通过助行器等步态辅助工具来处理。相比之下，远端肌肉无力可通过矫形器来处理。保持步态有助于维持日常功能并融入社会。
