Mueller M J, Minor S D, Schaaf J A, Strube M J, Sahrmann S A
Program of Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA.
Phys Ther. 1995 Aug;75(8):684-93. doi: 10.1093/ptj/75.8.684.
Limited ankle plantar-flexor moments and power during walking have been documented in several patient populations and are believed to contribute to gait deviations. The primary purpose of this study was to determine the relationship of plantar-flexor peak torque (PFPT) and dorsiflexion range of motion (ROM) to peak ankle moments and power during walking in a group of subjects without diabetes mellitus (DM) and in a group of subjects with DM and associated peripheral neuropathies.
Nineteen subjects, 9 with DM and associated peripheral neuropathies (mean age = 58 years, SD = 14, range = 35-75 years) and 10 without DM (mean age = 57 years, SD = 11, range = 37-68 years), were evaluated.
The following data were collected on all subjects: PFPT, dorsiflexion ROM, and ankle moments and power during walking (using a two-dimensional link-segment model). Hierarchical multiple regression was used for data analysis.
Plantar-flexor peak torque made substantial contributions to the ankle moment (40%) and ankle plantar-flexor power (53%) during walking. There also was a high correlation between PFPT and dorsiflexion ROM (r = .78) and between dorsiflexion ROM and ankle power (r = .72).
Plantar-flexor peak torque and dorsiflexion ROM are interrelated and appear to be important factors that contribute to ankle plantar-flexor moments and power during walking. This finding suggests that increasing PFPT and dorsiflexion ROM may help decrease gait deviations such as decreased step length and walking speed. When increasing PFPT is not possible, the natural occurrence of limited dorsiflexion ROM may help to maximize ankle moments during walking. Further research is needed to test whether these proposed treatment strategies can have a clinically useful effect. [Mueller MJ, Minor SD, Schaaf JA, et al. Relationship of plantar-flexor peak torque and dorsiflexion range of motion to kinetic variables during walking.
在多个患者群体中均已证实，步行过程中踝关节跖屈力矩和力量有限，且人们认为这会导致步态偏差。本研究的主要目的是确定一组无糖尿病（DM）受试者以及一组患有DM及相关周围神经病变的受试者在步行过程中，跖屈峰值扭矩（PFPT）和背屈活动范围（ROM）与踝关节峰值力矩和力量之间的关系。
对19名受试者进行了评估，其中9名患有DM及相关周围神经病变（平均年龄 = 58岁，标准差 = 14，范围 = 35 - 75岁），10名无DM（平均年龄 = 57岁，标准差 = 11，范围 = 37 - 68岁）。
收集了所有受试者的以下数据：PFPT、背屈ROM以及步行过程中的踝关节力矩和力量（使用二维环节模型）。采用分层多元回归进行数据分析。
步行过程中，跖屈峰值扭矩对踝关节力矩（40%）和踝关节跖屈力量（53%）有显著贡献。PFPT与背屈ROM之间（r = 0.78）以及背屈ROM与踝关节力量之间（r = 0.72）也存在高度相关性。
跖屈峰值扭矩和背屈ROM相互关联，似乎是步行过程中导致踝关节跖屈力矩和力量的重要因素。这一发现表明，增加PFPT和背屈ROM可能有助于减少步态偏差，如步长和步行速度降低。当无法增加PFPT时，背屈ROM受限的自然情况可能有助于在步行过程中使踝关节力矩最大化。需要进一步研究来测试这些提出的治疗策略是否能产生临床有用的效果。[穆勒MJ、迈纳SD、沙夫JA等。步行过程中跖屈峰值扭矩和背屈活动范围与动力学变量的关系。
