健康人群及关节疾病患者步态分析中时间-距离、力学及运动学和动态肌电参数的变化(英文)  

Changes in the gait analysis associated parameters of healthy people and patients with joint disease

作　　者：白跃宏[1] 周俊[1] 梁娟[1] 

机构地区：[1]上海交通大学附属第六人民医院康复医学科,上海市200233

出　　处：《中国组织工程研究与临床康复》2007年第9期1790-1793,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景: 步态分析可将矫形外科检查和康复治疗中沿用已久的定性分析和直观描述转换为客观、精确的定量评定。目的: 观测健康人群和患有脊柱及髋、膝、踝关节疾病患者步态分析中的时间- 距离参数、运动学参数、力学参数和动态肌电参数。设计: 对比观察, 对照实验。对象: 选择 2004- 12/2005- 07 上海交通大学附属第六人民医院康复医学科手术和康复治疗的 112 例患有脊柱及髋、膝、踝关节疾病手术或非手术治疗的患者。男性 42 例, 年龄(46±2) 岁; 女性 70 例, 年龄(41±4)岁。其中颈椎病患者 21 例, 腰椎间盘突出症及腰椎管狭窄症 26 例, 髋关节( 包括全髋关节置换术) 、膝关节( 包括前十字韧带重建术、全膝关节置换术) 、踝关节( 包括马蹄内翻足) 疾病分别 12, 34, 19 例。同期选择 40名健康志愿者( 均为上海交通大学附属第六人民医院员工) 为对照组, 年龄 20￣40 岁。纳入对象均对观测指标知情同意。方法: 应用三维步态分析系统( 英国 VICON 公司制, V- 612) 对 40 名健康志愿者和 112 例患有脊柱及髋、膝、踝关节疾病患者进行步态分析。主要观察指标: 受试者行走中的时间- 距离参数( 步长、步速、步频) 、下肢各关节运动学参数( 髋、膝、踝关节冠状轴角度) 、下肢各关节生物力学参数( 髋、膝、踝关节应力垂直轴分力) 及动态肌电参数( 股外侧肌表面肌电信号) 的变化。结果: 健康者 40 名和脊柱及下肢各关节疾病患者 112 例均进入结果分析。①时间- 距离参数: 脊柱疾病、髋关节疾病、膝关节疾病、踝关节疾病患者步频、步长、步速均明显低于 / 慢于对照组(P < 0.05￣0.01) 。②下肢各关节运动学参数及生物力学参数: 左侧前十字韧带重建术后 1 年患者支撑相初期左膝伸膝较右膝下降 9°, 支撑相初期左膝关节应力较右膝关节明显下降; 左侧全髋关节成形术BACKGROUND：Gait analysis enable to convert qualitative analysis and description used for a long time in orthopedic examination and rehabilitative treatment into objective and precise quantitative assessment. At the present, with the development of science and technology, three-dimensional （3D） gait analysis is more and more widely, extensively used in orthopedic surgery and rehabilitation medicine abroad, while much less in China. OBJECTIVE： To study the parameters of time-distance, kinematics, kinetic and electromyography （EMG） in healthy subjects and patients with backbone, hip, knee or ankle joint diseases. DESIGN ： Comparative observation and control study PARTICIPANTS： From December 2004 to July 2005, 40 healthy subjects and 112 patients suffering from backbone and hip, knee, ankle joint disease were selected from the Department of Rehabilitative Medicine, Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University and analyzed by three dimensional gait analysis system （VICON 612 system made by Britain VICON Company）. 112 patients including 42 males with the mean age of （46.2±2.3） years and 70 females with the mean age （41.2 ± 3.5） years were screened by skilled clinicians after surgical and rehabilitative treatment. Among them there were 21 patients with cervical vertebra, 26 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis. The number of hip, knee, ankle joint disease was 12, 34, 19 respectively. Total hip replacement was included in hip joint disease, anterior cruciate ligament （ACL） reconstruction was included in knee joint disease, talipes equinovarus was included in ankle joint disease. Meanwhile, 40 healthy subjects who were 20-40 years old, male or female, without any clinical symptom of backbone and limbs volunteered in the study. METHODS ：Gait analysis were carried out on 40 healthy volunteers and 112 operational and rehabilitative treatment patients with spinal and lower limb diseases using VICON 612 system made b

关 键 词：三维步态分析 矫形外科与康复医学 疗效评定 

分 类 号：R496[医药卫生—康复医学]