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6至12岁软骨发育不全儿童与年龄匹配的正常发育儿童对照组之间的步态参数差异。

Differences in gait parameters between children with achondroplasia and an age-matched control group of typically developed children in the age range of 6 to 12 years.

作者信息

Hergenröther Mareike, Palm Katja, Mohnike Klaus, Witte Kerstin

机构信息

Sports Engineering/ Movement Science Departement, Faculty for Human Sciences, Otto-von-Guericke University, Magdeburg, Germany.

Children' s Hospital, Otto-von-Guericke-University, Magdeburg, Germany.

出版信息

PLoS One. 2025 Jun 18;20(6):e0326184. doi: 10.1371/journal.pone.0326184. eCollection 2025.

Abstract

For people with achondroplasia, the ability to walk pain-free and longer distances is essential for maintaining independence and quality of life. However, due to shorter extremities and misalignments in the lower limbs, the walking pattern of this cohort is often affected. One possible contributing factor is an imbalanced foot-to-leg ratio. Although these structural differences are well documented, research on their specific impact on gait mechanics remains limited. In particular, no studies have investigated how an imbalanced foot-to-leg ratio, among other potential factors, may influence kinematic and kinetic parameters throughout the gait cycle. Therefore, this study examined gait differences between children with achondroplasia (N = 15) and an age-matched (6-12 y) control group (N = 15). Using a 3D motion capture system (Vicon, 13 cameras) and a modified Plug-in-Gait model, spatio-temporal, kinematic, and kinetic parameters were analyzed. Statistical parametric mapping was applied to identify key moments in the gait cycle where significant deviations occurred between the two cohorts. Results showed that all spatio-temporal parameters, except cadence, differed significantly between the groups (p < 0.05). Most kinematic and kinetic parameters also showed significant differences, particularly around initial contact and toe-off. Notably, kinematic deviations were found at the pelvis, hip, and ankle during initial contact. Around toe-off, ankle kinematics were significantly different (p = 0.006). Kinetic differences at the hip and knee in both planes were also evident around toe-off. These findings suggest that an imbalanced foot-to-leg ratio may influence gait patterns, particularly during initial contact and toe-off phases. However, additional factors contributing to these deviations remain to be identified. Further research is necessary to elucidate these influences, which could support the development of more targeted and individualized therapeutic interventions for individuals with ACH.

摘要

对于患有软骨发育不全的人来说,能够无痛行走且行走距离更长对于维持独立性和生活质量至关重要。然而,由于四肢较短以及下肢排列不齐,这一群体的行走模式常常受到影响。一个可能的促成因素是足腿比例失衡。尽管这些结构差异已有充分记录,但关于它们对步态力学的具体影响的研究仍然有限。特别是,尚无研究调查足腿比例失衡以及其他潜在因素如何在整个步态周期中影响运动学和动力学参数。因此,本研究检查了软骨发育不全儿童(N = 15)与年龄匹配(6 - 12岁)的对照组(N = 15)之间的步态差异。使用3D运动捕捉系统(Vicon,13台摄像机)和改进的插件式步态模型,分析了时空、运动学和动力学参数。应用统计参数映射来识别步态周期中两个队列之间出现显著偏差的关键时刻。结果表明,除步频外,所有时空参数在两组之间均存在显著差异(p < 0.05)。大多数运动学和动力学参数也显示出显著差异,特别是在初始接触和离地阶段。值得注意的是,在初始接触时,骨盆、髋部和脚踝处发现了运动学偏差。在离地时,脚踝运动学存在显著差异(p = 0.006)。在离地时,髋部和膝盖在两个平面上的动力学差异也很明显。这些发现表明,足腿比例失衡可能会影响步态模式,特别是在初始接触和离地阶段。然而,导致这些偏差的其他因素仍有待确定。有必要进行进一步研究以阐明这些影响,这可能有助于为软骨发育不全患者开发更具针对性和个性化的治疗干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/557a/12176110/34ee7fcb19f6/pone.0326184.g001.jpg

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