Joint kinematics and SPM analysis of gait in children with and without Down syndrome

IF 1.6 3区 心理学 Q4 NEUROSCIENCES Human Movement Science Pub Date : 2024-03-23 DOI:10.1016/j.humov.2024.103213
Matthew Beerse , Kaylee Larsen , Tasnuva Alam , Amy Talboy , Jianhua Wu
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Abstract

Background

Individuals with Down syndrome (DS) walk with altered gait patterns compared to their typically developing (TD) peers. While walking at faster speeds and with external ankle load, preadolescents with DS demonstrate spatiotemporal and kinetic improvements. However, evidence of joint kinematic adjustments is unknown, which is imperative for targeted rehabilitation design.

Research question

How does increasing walking speed and adding ankle load affect the joint kinematics of children with and without DS during overground walking?

Methods

In this cross-sectional observational study, thirteen children with DS aged 7–11 years and thirteen age- and sex-matched TD children completed overground walking trials. There were two speed conditions: normal speed and fast speed (as fast as possible without running). There were two load conditions: no load and ankle load (2% of body mass added bilaterally above the ankle). A motion capture system was used to register the ankle, knee, and hip joint angles in the sagittal plane. Peak flexion/extension angles, range of motion, and timing of peak angles were identified. In addition, statistical parametric mapping (SPM) was conducted to evaluate the trajectory of the ankle, knee, and hip joint angles across the entire gait cycle.

Results and significance

SPM analysis revealed the DS group walked with greater ankle, knee, and hip flexion compared to the TD group for most of the gait cycle, regardless of condition. Further, increasing walking speed led to improved ankle joint kinematics in both groups by shifting peak plantarflexion closer to toe-off. However, knee extension during stance was challenged in the DS group. Adding ankle load improved hip and knee kinematics in both groups but reduced peak plantarflexion around toe-off. The kinematic adjustments in the DS group suggest specific motor strategies to accommodate their neuromuscular deficits, which can provide a foundation to design targeted gait-based interventions for children with DS.

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唐氏综合征儿童和非唐氏综合征儿童的关节运动学和步态 SPM 分析
背景唐氏综合症(DS)患者与发育正常(TD)的同龄人相比,步态发生了改变。当以较快的速度行走并承受踝关节外部负荷时,患有唐氏综合症的青少年在时空和运动方面都有所改善。研究问题在地面行走过程中,提高行走速度和增加踝关节负荷对患有和不患有 DS 的儿童的关节运动学有何影响?方法在这项横断面观察性研究中,13 名 7-11 岁患有 DS 的儿童和 13 名年龄和性别匹配的 TD 儿童完成了地面行走试验。试验分为两种速度条件:正常速度和快速速度(尽可能快而不奔跑)。有两种负载条件:无负载和踝关节负载(在踝关节上方双侧增加体重的 2%)。运动捕捉系统用于记录矢状面上的踝关节、膝关节和髋关节角度。确定了屈伸角度峰值、运动范围和角度峰值出现的时间。此外,还进行了统计参数绘图(SPM),以评估踝关节、膝关节和髋关节角度在整个步态周期中的轨迹。结果和意义SPM分析表明,与TD组相比,DS组在大部分步态周期中的踝关节、膝关节和髋关节屈曲度更大,与条件无关。此外,步行速度的增加使两组的踝关节运动学都得到了改善,跖屈峰值更接近脚尖。然而,在 DS 组中,站立时的膝关节伸展受到了挑战。增加踝关节负荷改善了两组的髋关节和膝关节运动学特性,但降低了脚尖起点附近的跖屈峰值。DS组的运动学调整表明,他们有特定的运动策略来适应其神经肌肉缺陷,这为针对DS儿童设计有针对性的步态干预奠定了基础。
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来源期刊
Human Movement Science
Human Movement Science 医学-神经科学
CiteScore
3.80
自引率
4.80%
发文量
89
审稿时长
42 days
期刊介绍: Human Movement Science provides a medium for publishing disciplinary and multidisciplinary studies on human movement. It brings together psychological, biomechanical and neurophysiological research on the control, organization and learning of human movement, including the perceptual support of movement. The overarching goal of the journal is to publish articles that help advance theoretical understanding of the control and organization of human movement, as well as changes therein as a function of development, learning and rehabilitation. The nature of the research reported may vary from fundamental theoretical or empirical studies to more applied studies in the fields of, for example, sport, dance and rehabilitation with the proviso that all studies have a distinct theoretical bearing. Also, reviews and meta-studies advancing the understanding of human movement are welcome. These aims and scope imply that purely descriptive studies are not acceptable, while methodological articles are only acceptable if the methodology in question opens up new vistas in understanding the control and organization of human movement. The same holds for articles on exercise physiology, which in general are not supported, unless they speak to the control and organization of human movement. In general, it is required that the theoretical message of articles published in Human Movement Science is, to a certain extent, innovative and not dismissible as just "more of the same."
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