Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa, 1-243 Medical Education Building, Iowa City, IA 52242, USA.
Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa, 1-243 Medical Education Building, Iowa City, IA 52242, USA.
Clin Biomech (Bristol). 2024 Dec;120:106357. doi: 10.1016/j.clinbiomech.2024.106357. Epub 2024 Oct 2.
Gait retraining, which typically focuses on the most severely affected limb or joint, has shown promising results in treating faulty running and walking patterns. The closed-chain nature of gait during the stance phase may influence kinematic changes in the adjacent joints of the trained leg. In addition, the coupled nature of the lower extremity motion of gait suggests that changes in one leg may transfer to the other. This study aimed to assess the intra- and inter-limb transfer of kinematic changes following gait retraining to reduce knee extension in individuals with hyperextension walking patterns.
Seventeen women with knee hyperextension gait patterns participated in six treadmill retraining sessions. All participants received verbal and real-time visual kinematic feedback in the form of knowledge of results. This intervention study took place at the Gait Analysis Laboratory at the University of Iowa. Mean peak sagittal-plane lower extremity joint kinematics during overground walking at pretraining, post-training, and 1- and 8-month follow-ups were calculated for analysis and comparisons.
The post-training changes in ankle range of motion returned to baseline values by the 8-month follow-up. There was a significant transfer effect of kinematic changes to the untrained knee following gait retraining.
Training one knee did not result in long-term compensatory kinematic changes in the other joints. In addition, the improvements in knee extension range of motion were transferred to the untrained knee and retained at the 8-month follow-up. This study supports the use of gait retraining as an effective clinical intervention.
步态再训练通常侧重于受影响最严重的肢体或关节，已显示出治疗错误跑步和行走模式的有前景的结果。站立阶段步态的闭链性质可能会影响训练腿相邻关节的运动学变化。此外，步态下肢运动的耦合性质表明一条腿的变化可能会转移到另一条腿。本研究旨在评估步态再训练后减少膝关节伸展的情况下，运动学变化的肢体内和肢体间转移，以减少膝关节伸展的个体中过度伸展的行走模式。
17 名膝关节伸展步态模式的女性参加了 6 次跑步机再训练课程。所有参与者都接受了口头和实时视觉运动学反馈，以知识结果的形式提供。这项干预研究在爱荷华大学的步态分析实验室进行。在预训练、训练后以及 1 个月和 8 个月的随访期间，计算了在地面行走过程中矢状面下肢关节运动学的平均峰值，以进行分析和比较。
踝关节运动范围的训练后变化在 8 个月的随访中恢复到基线值。步态再训练后，未训练的膝关节出现明显的运动学变化转移效应。
训练一条腿不会导致其他关节的长期代偿性运动学变化。此外，膝关节伸展范围的改善转移到未训练的膝盖并在 8 个月的随访中保留。这项研究支持将步态再训练作为一种有效的临床干预措施。
