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特发性脊柱侧弯患者的步态及密尔沃基支具对步态的影响研究(作者译)

[Investigation of gait of patients with idiopathic scoliosis and the influence of the Milwaukee brace on gait (author's transl)].

作者信息

Güth V, Abbink F, Götze H G, Heinrichs W

出版信息

Z Orthop Ihre Grenzgeb. 1978;116(5):631-40.

PMID:716552
Abstract

We investigated 42 juvenile patients with idiopathic scoliosist, 37 of them were provided with a Milwaukee brace and treated physically. The electromyographic activity of the musculi erectores trunci and the musculi glutaei medii were recorded during walking and standing on one leg. Simultaneously the motions of the trunc and the pelvis in the frontal plane were registered and calculated. Results without the brace: During walking the activity of the erectors trunci predominates on the convex side of the curvature of the spine. This applies as to the functional curve. The M. glutaeus medius shows an increased activity on the contralateral side of the overhang of the trunc. The priodical shifts of the trunc to the right and to the left during walking decrease with increasing activity of the M. glutaeus medius. In this way, we show the stabilizing influence of this muscle upon the statics of the spine. This should be especially considered with regard to the physical treatment of the patients. Results with the brace put on: There is only little influence of the brace upon the electrical activity of the musculi erectores trunci: we could not detect any activating ore inactivating effect of the brace. The amplitude of the periodical shifts of the trunc and the perlvis during walking is reduced by the brace. At the same time we found a greater activity of the musculi glutaei medii than with the brace taken off. We suppose that the reduced shifts of the trunc and the pelvis involved by the brace force a greater activity of the glutaeus medius.

摘要

我们研究了42例特发性脊柱侧凸的青少年患者,其中37例佩戴密尔沃基支具并接受物理治疗。在单腿行走和站立过程中记录了竖脊肌和臀中肌的肌电活动。同时,记录并计算了躯干和骨盆在额状面内的运动。未佩戴支具时的结果:行走过程中,竖脊肌的活动在脊柱侧弯凸侧占主导。这适用于功能性曲线。臀中肌在躯干突出对侧的活动增加。行走过程中躯干左右周期性摆动随着臀中肌活动增加而减少。通过这种方式,我们展示了该肌肉对脊柱静态平衡的稳定作用。在对患者进行物理治疗时应特别考虑这一点。佩戴支具时的结果:支具对竖脊肌电活动影响很小:我们未检测到支具的任何激活或失活作用。行走过程中躯干和骨盆周期性摆动的幅度因支具而减小。同时,我们发现佩戴支具时臀中肌的活动比摘下支具时更大。我们推测,支具引起的躯干和骨盆摆动减少迫使臀中肌活动增加。

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