Gait & posture最新文献

Ankle-hip joint trade-off in normal gait: Exploring the kinematic influence of the medial longitudinal arch of the foot

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-25 DOI: 10.1016/j.gaitpost.2024.11.011

Hayato Kawaji , Satoru Kojima

Background

In human gait, leg progression into the swing phase involves two primary strategies: ankle plantar flexion and hip flexion. These strategies are believed to exhibit a trade-off relationship; however, it is unclear whether this relationship holds for normal gait and the role of the medial longitudinal arch (MLA) in shaping these strategies.

Research questions

Does a trade-off relationship exist between ankle plantar flexion and hip flexion strategies during normal gait in young healthy adults? Do the kinematics of MLA during gait influence the strategies during leg progression into the swing phase?

Methods

Data from 36 young healthy adults were analyzed. Gait speed and peak moment, angular impulse, peak power and joint work at ankle plantar flexion and hip flexion were assessed within the context of the normal gait task. The parameters were also assessed using ankle-to-hip joint ratios (ankle/hip indices). Kinematics of MLA, including peak MLA angle, amount of descent, and amount of elevation during gait, were also measured. To exclude the effect of gait speed, partial correlation coefficients were employed to explore the relationship between ankle and hip variables as well as the ratio of ankle/hip indices and MLA kinematics.

Results

A significant negative correlation between ankle plantar flexion work and hip flexion work was detected. Moreover, a positive correlation between the ankle plantar flexion work to hip flexion work ratio and MLA elevation was detected.

Significance

A trade-off relationship between ankle plantar flexion and hip flexion strategies during normal gait in young healthy adults was confirmed, suggesting that these parameters are fundamental to normal gait. Additionally, the MLA elevation during late stance may influence the establishment of ankle plantar flexion and hip flexion strategies. These findings enhance our understanding of gait mechanisms and highlight the role of MLA kinematics in shaping gait strategies.

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引用次数: 0

In Vivo Assessment of Shoulder Stability in Dynamic Rehabilitation Exercises: A Scoping Review 动态康复训练中肩部稳定性的体内评估：范围审查

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-23 DOI: 10.1016/j.gaitpost.2024.11.010

Laura Ramírez-Pérez , Graham K. Kerr , Antonio I. Cuesta-Vargas

Background

The shoulder complex, which has the highest prevalence of instability, is currently, the subject of considerable debate regarding the methodologies used to assess shoulder stability during dynamic exercises.

Research question

The primary aim is to summarize evidence on various methodologies used to evaluate shoulder stability during dynamic exercises.

Methods

This scoping review included cross-sectional studies focusing on various evaluation techniques to assess shoulder forces, kinetics, and stability during dynamic movements. In analyzing each study, the selected data included population profile, sample size, exercise type, and evaluation methodology used.

Results

Twenty-seven studies with a total of 1187 subjects were included. Among the studies, various dynamic exercises were evaluated, including throwing exercises, movements with dumbbells or elastic bands, push-ups, and functional tasks. Most evaluation techniques were combined, with eleven studies using surface electromyography; seven used dynamometers to obtain direct strength measurements; two used six-force axis sensors; one utilized force platforms; and one was focused on the loss of speed using linear velocity transducers. Furthermore, motion capture systems such as high-speed cameras were used in fourteen studies. In conclusion, surface electromyography and high-speed cameras are the primary techniques for measuring muscle activity and kinetic and kinematic data. However, they do not directly measure glenohumeral stability, meaning further research is needed to develop reliable methodologies for this purpose.

Significance

This study holds significant relevance in the field of shoulder instability and has clear clinical implications, as it establishes the primary tools for estimating glenohumeral stability, which could enable patient stratification and the design of optimal intervention programs based on these measurements.

研究背景肩关节复合体是不稳定性发生率最高的部位，目前有关动态运动中肩关节稳定性评估方法的争论相当激烈。研究问题主要目的是总结动态运动中肩关节稳定性评估方法的相关证据。在分析每项研究时，所选数据包括人口概况、样本大小、运动类型和所使用的评估方法。在这些研究中，对各种动态运动进行了评估，包括投掷运动、哑铃或弹力带运动、俯卧撑和功能性任务。大多数评估技术都是综合使用的，其中 11 项研究使用了表面肌电图；7 项研究使用测力计直接测量力量；2 项研究使用了六力轴传感器；1 项研究使用了力平台；1 项研究使用线性速度传感器关注速度损失。此外，有 14 项研究使用了高速摄像机等运动捕捉系统。总之，表面肌电图和高速摄像机是测量肌肉活动以及运动和运动学数据的主要技术。这项研究在肩关节不稳定性领域具有重要意义，并具有明确的临床意义，因为它确立了估测盂肱稳定性的主要工具，可根据这些测量结果对患者进行分层并设计最佳干预方案。

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引用次数: 0

Quality, kinematics, and self-reported comfort of gait during body weight support in young adults with gait impairments – A cross-sectional study 有步态障碍的年轻成年人在体重支撑时的步态质量、运动学和自我报告的舒适度 - 一项横断面研究

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-22 DOI: 10.1016/j.gaitpost.2024.11.014

Morten Bøgelund Pedersen , Morten Bilde Simonsen , Per Aagaard , Anders Holsgaard-Larsen

Background

Body weight support (BWS) technologies offer effective gait training for individuals with neurological gait impairments. However, varying dynamic BWS levels may impact specific gait kinematics, potentially introducing maladaptive movement patterns.

Aim

To investigate the acute impact of different levels of dynamically modulated BWS during overground walking at a self-selected speed on gait quality, kinematic gait patterns, and self-reported gait comfort in young adults with gait impairments.

Methods

Three-dimensional gait analysis was conducted on 18 individuals with neurological gait impairments during overground walking with 0, 10, 20, 30, 40, and 50 % BWS using a novel robotic unloading device. Gait quality, expressed as Gait Deviation Index (GDI), lower limb joint kinematics, and spatiotemporal parameters were obtained for one representative stride per participant at each BWS level. Gait comfort was reported on a visual analogue scale (VAS) for each unload level. Time-continuous data were analysed using statistical parametric mapping; discrete data were compared between BWS levels using paired t-tests.

Results

Compared with habitual gait (0 % BWS), GDI was unaltered with increasing BWS. The relative shapes of kinematic trajectories were largely unaffected, with minor reductions in amplitude and a limited impact on temporal effects with increasing BWS. Most spatiotemporal parameters were unaltered by changes in BWS, although negative impacts on walking speed, cadence, and step length emerged at 40 % BWS, with a more pronounced impact at 50 % BWS. Gait comfort improved at 20–30 % BWS by up to 20 mm on a 0–100 mm VAS.

Conclusion

Participants maintained habitual (0 % BWS) biomechanical gait patterns with 10–30 % BWS, experiencing increased gait comfort at 20–30 % BWS. Dynamically modulated BWS can be applied in task-specific gait training to offer vertical body support and increased comfort with little to no impact on biomechanical movement patterns.

背景体重支撑（BWS）技术可为神经性步态障碍患者提供有效的步态训练。目的研究有步态障碍的年轻人在以自选速度进行地面行走时，不同水平的动态调节体重支撑对步态质量、步态运动模式和自我报告步态舒适度的急性影响。方法使用新型机器人卸载装置，对 18 名神经性步态障碍患者在 0、10、20、30、40 和 50% BWS 条件下进行地面行走时的步态进行三维分析。以步态偏差指数（GDI）、下肢关节运动学和时空参数表示的步态质量，在每个 BWS 水平下获得了每个参与者的一个代表性步幅。步态舒适度以视觉模拟量表（VAS）报告每个卸载水平的步态舒适度。结果与习惯步态（0% BWS）相比，GDI 随 BWS 的增加而不变。运动轨迹的相对形状基本未受影响，随着 BWS 的增加，振幅略有降低，对时间效应的影响有限。大多数时空参数不受 BWS 变化的影响，但在 40% BWS 时会对步行速度、步幅和步长产生负面影响，在 50% BWS 时影响更为明显。结论参与者在使用 10-30% BWS 时保持了习惯的（0% BWS）生物力学步态模式，在使用 20-30% BWS 时步态舒适度有所提高。动态调节的 BWS 可用于特定任务的步态训练，为身体提供垂直支撑并提高舒适度，对生物力学运动模式几乎没有影响。

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引用次数: 0

The role of waddling gait in balance control during pregnancy 蹒跚步态在孕期平衡控制中的作用

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-22 DOI: 10.1016/j.gaitpost.2024.11.015

Zahra Abedzadehzavareh , Robert D. Catena

Background

Pregnant people experience many physical changes which might affect their walking pattern. Waddling gait is a common gait pattern pregnant individuals adopt. It is unknown whether waddling gait is a sign of poor balance or a protective mechanism against loss of balance, so the aim of this study was to understand why some pregnant individuals adopt this gait pattern.

Methods

We assessed twenty-three pregnant individuals longitudinally in 4-week intervals between 18 and 34 weeks of gestation. Participants completed a quiet standing balance trial and a walking trial. We measured spatiotemporal variables and body center of mass motion, from which we derived measures of balance and gait energetics. Forward-step multiple linear regression analyses were used to explore the correlation between step width (as a measure of waddling) and the other variables.

Results

We found a positive correlation between change in step width average and change in lateral motion of the center of mass during walking (R²=0.624, P<0.001) and change in step width standard deviation and change in minimum center of gravity distance to the lateral border (R²=0.339, p=0.004), suggesting wider steps help recapture balance during pregnancy. Surprisingly, no significant relationship was found between change in step width and changes in energy recovery (p=0.341) or mechanical work (p=0.482), indicating that taking wider steps is not inefficient. A negative correlation between change in step width and change in standing anteroposterior center of mass motion (R²=0.315, p=0.005) suggests better balance control among people that adopt a waddling gait pattern.

Significance

This study suggests that waddling gait is a protective mechanism during pregnancy. Clinicians and prosthetists can use this insight to promote step width during walking among pregnant individuals to increase their safety.

背景孕妇经历了许多身体变化，这些变化可能会影响她们的行走方式。蹒跚步态是孕妇常见的步态。目前还不清楚蹒跚步态是平衡能力差的表现还是防止失去平衡的保护机制，因此本研究的目的是了解为什么有些孕妇会采用这种步态。受试者完成了安静站立平衡试验和步行试验。我们测量了时空变量和身体质心运动，从中得出了平衡和步态能量的测量值。结果我们发现，步宽平均值的变化与行走时质心横向运动的变化（R2=0.624，P<0.001）以及步宽标准偏差的变化与最小重心到侧边距离的变化（R2=0.339，P=0.004）之间存在正相关，这表明更宽的步幅有助于在孕期恢复平衡。令人惊讶的是，在步幅变化与能量恢复（p=0.341）或机械功（p=0.482）的变化之间没有发现明显的关系，这表明迈出更宽的步伐并非效率低下。步幅变化与站立前胸质心运动变化之间的负相关（R2=0.315，p=0.005）表明，采用蹒跚步态的人平衡控制能力更好。临床医生和假肢制作者可以利用这一观点来促进孕妇在行走过程中的步幅，以提高她们的安全性。

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引用次数: 0

Biomechanical predictors of primary ACL injury: A scoping review of prospective studies 前交叉韧带原发性损伤的生物力学预测因素：前瞻性研究范围综述

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-20 DOI: 10.1016/j.gaitpost.2024.11.013

Rachel K. Straub, Christopher M. Powers

Background

ACL injuries commonly occur in non-contact situations, particularly in sports involving jumping, landing, and cutting. Numerous biomechanical predictors for non-contact ACL injury have been proposed, yet existing reviews on biomechanical predictors vary in scope and findings.

Research question

This review aims to identify biomechanical predictors of primary ACL injury using a scoping review.

Methods

PubMed and EBSCO host (CINAHL Complete, MEDLINE Complete, SPORTDiscus) were searched from inception to March 1, 2023. Prospective studies that (1) examined discrete kinematic/kinetic variables during whole body movements (e.g., landing from a jump, cutting, and single-leg squatting) using 3D lab-based motion analysis, 2D video, or observational (non-instrumented) methods; and (2) produced a prediction model for the association between biomechanical variables (independent variable) and primary ACL injury (dependent variable) were included.

Results

11 studies were included. Jump-landing tasks were the most studied (9 studies), followed by change in direction (2 studies) and single-leg squatting (2 studies). Significant biomechanical predictors for non-contact ACL injury were reported in 7 studies during jump-landing/change in directions tasks. Kinematic predictors included decreased flexion (hip and knee) and increased knee valgus/internal rotation. Kinetic predictors included increased vertical ground reaction forces (landing/takeoff) and increased knee moments (valgus and knee extensor). Limited/conflicting evidence was found for all predictors. None of studies that employed 2D or observational methods (n=3) were able to identify predictors of ACL injury.

Significance

Biomechanical predictors of primary ACL injury were identified in 7 of 11 prospective studies included within this scoping review. The majority of the reported risk factors were identified using the drop jump, which was the most studied task (8 of 11 studies). The lack of standardization in biomechanical testing across studies limits the determination of specific predictive variables for primary ACL injury.

背景前交叉韧带损伤通常发生在非接触情况下，尤其是在涉及跳跃、着地和切入的运动中。研究问题本综述旨在通过范围界定综述确定原发性前交叉韧带损伤的生物力学预测因素。方法检索了从开始到 2023 年 3 月 1 日期间的 PubMed 和 EBSCO 主机（CINAHL Complete、MEDLINE Complete、SPORTDiscus）。前瞻性研究包括：(1) 使用基于实验室的三维运动分析、二维视频或观察（非仪器）方法对全身运动（如跳跃着地、切入和单腿下蹲）过程中的离散运动学/动力学变量进行检查；(2) 针对生物力学变量（自变量）和原发性前交叉韧带损伤（因变量）之间的关联建立预测模型。研究最多的是跳跃着地任务（9 项研究），其次是改变方向（2 项研究）和单腿深蹲（2 项研究）。有 7 项研究报告称，在跳跃落地/改变方向任务中，非接触性前交叉韧带损伤的生物力学预测因素显著。运动学预测因素包括屈曲减少（髋关节和膝关节）和膝关节内翻/内旋增加。运动学预测因素包括垂直地面反作用力增加（着地/起飞）和膝关节力矩增加（外翻和膝关节外展）。所有预测指标的证据都很有限/相互矛盾。在采用二维或观察法的研究（3 项）中，没有一项研究能够确定前交叉韧带损伤的预测因素。大多数报告的风险因素都是通过落体跳来确定的，这也是研究最多的任务（11 项研究中的 8 项）。不同研究的生物力学测试缺乏标准化，这限制了对原发性前交叉韧带损伤特定预测变量的确定。

{"title":"Biomechanical predictors of primary ACL injury: A scoping review of prospective studies","authors":"Rachel K. Straub, Christopher M. Powers","doi":"10.1016/j.gaitpost.2024.11.013","DOIUrl":"10.1016/j.gaitpost.2024.11.013","url":null,"abstract":"<div><h3>Background</h3><div>ACL injuries commonly occur in non-contact situations, particularly in sports involving jumping, landing, and cutting. Numerous biomechanical predictors for non-contact ACL injury have been proposed, yet existing reviews on biomechanical predictors vary in scope and findings.</div></div><div><h3>Research question</h3><div>This review aims to identify biomechanical predictors of primary ACL injury using a scoping review.</div></div><div><h3>Methods</h3><div>PubMed and EBSCO host (CINAHL Complete, MEDLINE Complete, SPORTDiscus) were searched from inception to March 1, 2023. Prospective studies that (1) examined discrete kinematic/kinetic variables during whole body movements (e.g., landing from a jump, cutting, and single-leg squatting) using 3D lab-based motion analysis, 2D video, or observational (non-instrumented) methods; and (2) produced a prediction model for the association between biomechanical variables (independent variable) and primary ACL injury (dependent variable) were included.</div></div><div><h3>Results</h3><div>11 studies were included. Jump-landing tasks were the most studied (9 studies), followed by change in direction (2 studies) and single-leg squatting (2 studies). Significant biomechanical predictors for non-contact ACL injury were reported in 7 studies during jump-landing/change in directions tasks. Kinematic predictors included decreased flexion (hip and knee) and increased knee valgus/internal rotation. Kinetic predictors included increased vertical ground reaction forces (landing/takeoff) and increased knee moments (valgus and knee extensor). Limited/conflicting evidence was found for all predictors. None of studies that employed 2D or observational methods (n=3) were able to identify predictors of ACL injury.</div></div><div><h3>Significance</h3><div>Biomechanical predictors of primary ACL injury were identified in 7 of 11 prospective studies included within this scoping review. The majority of the reported risk factors were identified using the drop jump, which was the most studied task (8 of 11 studies). The lack of standardization in biomechanical testing across studies limits the determination of specific predictive variables for primary ACL injury.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"116 ","pages":"Pages 22-29"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Valgus deformity of the distal tibia in children and adolescents with idiopathic flatfoot: Can it be predicted using 3D movement analysis? 特发性扁平足儿童和青少年胫骨远端内翻畸形：能否通过三维运动分析进行预测？

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-20 DOI: 10.1016/j.gaitpost.2024.11.012

Chakravarthy Ugandhar Dussa , Nadine Dostal , Harald Böhm

Background

Distal tibial valgus deformity, though common in various medical conditions, has not been extensively studied in idiopathic flatfoot. It clinically presents as hindfoot valgus, mimicking flatfoot deformity, and requires X-rays for detection. Severity is quantified using resting calcaneal angle and standing tibio-calcaneal angles (STCA), but their prognostic value for identifying distal tibial valgus deformity remains unclear. The use of routine invasive radiographs in idiopathic flatfoot is controversial as instrumented non-invasive gait analysis gains popularity for investigative purposes.

Research question

This study aimed to determine the prevalence of distal tibial valgus deformity in children and adolescents with idiopathic flatfoot using radiography and to identify parameters assessed during standing or walking that predict this deformity.

Methods

A retrospective study included outpatients aged 7–17 years with idiopathic flatfeet. Participants underwent clinical examination, foot and ankle X-rays, and instrumented 3-dimensional gait analysis. A lateral distal tibia angle (LDTA) < 86° indicated valgus deformity, with LDTA 86–92° considered normal. Two groups were analysed: ankle valgus (LDTA < 86°) and normal ankle (86–92°). STCA, ankle tilt, intermalleolar height difference (IMHD), and eight kinematic parameters were correlated with LDTA.

Results

The study included 136 patients (mean age 11.5 years, SD=2.2). Sixty-three patients had ankle valgus (LDTA 83.8°, SD=1.7°), and 73 had normal ankles (LDTA 88.8°, SD=1.3°), showing a significant difference between groups (p < 0.001). STCA during standing was the best predictor, though it explained only 9 % of variance, limiting robust prediction.

Significance

The prevalence of distal tibial valgus deformity was 42 % in idiopathic flatfoot cases, highlighting the necessity for routine ankle radiographs due to the inability to clinically suspect this deformity. Further studies should explore the biomechanical effects and their clinical implications for management.

背景：胫骨远端外翻畸形虽然常见于各种疾病，但对特发性扁平足的研究并不广泛。它在临床上表现为后足外翻，模仿扁平足畸形，需要通过 X 光检查才能发现。其严重程度可通过静止小腿骨角度和站立胫骨-小腿骨角度（STCA）进行量化，但其对识别胫骨远端外翻畸形的预后价值仍不明确。在特发性扁平足患者中使用常规有创X光片还存在争议，因为以调查为目的的仪器无创步态分析越来越受欢迎：本研究旨在通过放射摄影确定特发性扁平足儿童和青少年胫骨远端外翻畸形的患病率，并确定在站立或行走过程中评估的可预测该畸形的参数：这项回顾性研究纳入了7-17岁的特发性扁平足门诊患者。参与者接受了临床检查、足踝X光检查和仪器三维步态分析。胫骨外侧远端角度（LDTA）小于86°表示外翻畸形，LDTA在86-92°之间视为正常。分析分为两组：踝关节外翻（LDTA < 86°）和正常踝关节（86-92°）。STCA、踝关节倾斜度、两跖间高度差（IMHD）和八个运动学参数与 LDTA 相关：研究包括 136 名患者（平均年龄 11.5 岁，SD=2.2）。63名患者踝关节外翻（LDTA为83.8°，SD=1.7°），73名患者踝关节正常（LDTA为88.8°，SD=1.3°），两组间差异显著（P < 0.001）。站立时的 STCA 是最好的预测指标，但它只能解释 9% 的方差，限制了预测的准确性：在特发性扁平足病例中，胫骨远端外翻畸形的发生率为42%，由于临床上无法怀疑这种畸形，因此强调了常规踝关节X光检查的必要性。进一步的研究应探讨生物力学效应及其对治疗的临床影响。

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引用次数: 0

The impact of various subtypes of temporomandibular disorders on body balance – preliminary study 各种亚型颞下颌关节紊乱对身体平衡的影响--初步研究

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-20 DOI: 10.1016/j.gaitpost.2024.11.009

Aleksandra Dolina , Michał Baszczowski , Magdalena Zawadka , Lena Sobiech , Jacek Szkutnik , Piotr Gawda

Background

Balance disorders are considered a serious diagnostic challenge, with many potential causes. The influence of temporomandibular disorders (TMD) on postural balance has numerous anatomical, biomechanical, physiological and functional argumentation, however, cohort studies on this subject do not give unambiguous results. It is suggested that only some forms of TMD may affect the body balance. Research question: Will body balance parameters differ in patients with particular subtypes of temporomandibular disorders and without temporomandibular disorders? Methods: cohort study. A total of 25 participants with TMD (9 with myofascial subtype; 9 with disc disorders subtype; 7 with mixed diagnosis) and 11 participants without TMD (control group) diagnosed by Research Diagnostic Criteria for TMD were assessed for body balance changes using force platform FreeMED MAXI ground reaction force platform (Sensor Medica; Guidonia Montecelio, Roma, Italia) under different mandibular conditions (rest position, clenching, clenching on cotton rolls). For the statistical analysis, the postural sway area of the Center of Pressure (COP) and its velocity were used. Results: The greatest differences in the sway area of the COP and its velocity were noticed when comparing the control group and the group with myofascial disorders. Statistically significant differences regarding the sways of COP in different mandible conditions were also shown by intragroup analyses in the group with myofascial and mixed forms. Both the results of the intra- and intra-group analyses shows that the involvement of the muscular factor may determine the occurrence of deviations in the body balance. Significance: The results of the project may extend the diagnosis of patients with balance disorders to the diagnosis of the masticatory system to accurately determine the source of the patient's problem.

背景平衡失调被认为是一个严重的诊断难题，其潜在原因很多。颞下颌关节紊乱症（TMD）对姿势平衡的影响在解剖学、生物力学、生理学和功能学方面都有许多论据，但有关这一主题的队列研究并没有给出明确的结果。有人认为，只有某些形式的 TMD 可能会影响身体平衡。研究问题有特定亚型颞下颌关节紊乱症和无颞下颌关节紊乱症的患者的身体平衡参数是否会有所不同？方法：队列研究。根据 TMD 研究诊断标准确诊的 25 名 TMD 患者（9 名肌筋膜亚型患者；9 名椎间盘紊乱亚型患者；7 名混合诊断患者）和 11 名无 TMD 患者（对照组）在不同的下颌条件下（静止姿势、紧握、紧握棉卷），使用力平台 FreeMED MAXI 地面反作用力平台（Sensor Medica; Guidonia Montecelio, Roma, Italia）评估身体平衡的变化。统计分析使用了压力中心（COP）的姿势摇摆面积及其速度。结果显示对照组和肌筋膜障碍组在 COP 的摇摆面积和速度方面的差异最大。通过对肌筋膜疾病组和混合型疾病组的组内分析，不同下颌条件下 COP 摇摆的差异也具有统计学意义。组内和组内分析的结果都表明，肌肉因素的参与可能会决定身体平衡偏差的发生。意义重大：该项目的结果可将平衡失调患者的诊断扩展到咀嚼系统的诊断，从而准确确定患者问题的根源。

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引用次数: 0

Single-leg horizontal jump is more suitable for assessing lower limb function compared to single-leg vertical jump in patellofemoral pain patients 与单腿纵跳相比，单腿水平跳更适合评估髌骨股骨痛患者的下肢功能。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-16 DOI: 10.1016/j.gaitpost.2024.11.008

Hang Pan , Shengxing Fu , Yulin Zhou , Ting Long , Hanjun Li , Huijuan Shi

Background

The single-leg vertical jump (SLVJ) and single-leg horizontal jump (SLHJ) are commonly used assessments for individuals with lower limb injuries. Despite previous studies comparing these tasks across various individuals, their comparative effectiveness in evaluating lower limb function in individuals with patellofemoral pain (PFP) and any potential sex differences in these functional tests remain uncertain.

Research question

The purpose of this study was to determine which jump task is more suitable for functional assessment in PFP patients by comparing the differences in jump performance and biomechanical variables between PFP patients and healthy individuals during the SLVJ and SLHJ. Furthermore, the study aimed to determine whether the more suitable functional assessment for male and female PFP patients is consistent.

Methods

A total of 24 PFP patients (15 males, 9 females) and 17 healthy individuals (9 males, 8 females) were recruited. Three-dimensional kinematic and kinetic data were collected during the propulsion and landing phases of the SLVJ and SLHJ. Two-way ANOVA was used to compare each dependent variable between groups (PFP vs. healthy controls) and sex (male vs. female).

Results

Both male and female PFP groups presented a reduced jump distance than the control group in the SLHJ (p = 0.002), but no significant difference was detected in the SLVJ. Both male and female PFP groups displayed increased hip work (p = 0.005) and contribution (p = 0.009) and reduced knee work contribution (p = 0.034) during the propulsion phase of the SLHJ compared to the control group. Moreover, female participants of PFP and control groups performed shorter jump distances (p ≤ 0.001) and had less knee work (p < 0.001) during the propulsion phase of vertical and horizontal jumps than males.

Conclusion

Single-leg horizontal jump is more suitable for assessing lower limb function in PFP patients, characterized by reduced knee work contribution impacting jump performance, and this applies to both male and female PFP patients.

背景：单腿立定跳远（SLVJ）和单腿水平跳远（SLHJ）是评估下肢损伤患者的常用方法。尽管之前有研究对不同个体进行了这些任务的比较，但它们在评估髌骨股骨痛（PFP）患者下肢功能方面的比较效果以及这些功能测试的潜在性别差异仍不确定：本研究的目的是通过比较 PFP 患者和健康人在 SLVJ 和 SLHJ 中的跳跃表现和生物力学变量差异，确定哪种跳跃任务更适合用于 PFP 患者的功能评估。此外，该研究还旨在确定男性和女性 PFP 患者更适合的功能评估是否一致：方法：共招募了 24 名 PFP 患者（15 名男性，9 名女性）和 17 名健康人（9 名男性，8 名女性）。方法：共招募了 24 名 PFP 患者（15 名男性，9 名女性）和 17 名健康人（9 名男性，8 名女性），收集了 SLVJ 和 SLHJ 的推进和着陆阶段的三维运动学和动力学数据。采用双向方差分析对各组（PFP 与健康对照组）和性别（男性与女性）之间的因变量进行比较：在 SLHJ 中，男性和女性 PFP 组的跳跃距离均小于对照组（p = 0.002），但在 SLVJ 中未发现显著差异。与对照组相比，PFP 组男性和女性在 SLHJ 的推进阶段都显示出髋关节做功增加（p = 0.005）和贡献增加（p = 0.009），而膝关节做功贡献减少（p = 0.034）。此外，与男性相比，PFP 组和对照组的女性参与者的跳跃距离更短（p ≤ 0.001），在纵跳和横跳的推进阶段膝关节做功更少（p < 0.001）：结论：单腿水平跳更适合用于评估PFP患者的下肢功能，其特点是膝关节做功减少影响了跳跃表现，这适用于男性和女性PFP患者。

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引用次数: 0

Assessing upper limb functional use in daily life using accelerometry: A systematic review 使用加速度计评估日常生活中的上肢功能使用情况：系统综述。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-15 DOI: 10.1016/j.gaitpost.2024.11.003

Nieke Vets , Kaat Verbeelen , Jill Emmerzaal , Nele Devoogdt , Ann Smeets , Dieter Van Assche , Liesbet De Baets , An De Groef

Background

Upper limb dysfunctions are common and disabling in daily life. Accelerometer data are commonly used to describe upper limb use. However, different data analyzing methods are used to describe or classify upper limb use.

Research question

The purpose of this systematic review was to present an overview of the assessment and data-analysis methods using accelerometery, and to specify their accuracy and validity assessing upper limb functional use.

Methods

A systematic literature search was performed consulting the following databases: Pubmed, Embase, Scopus, Web of Science, Sport Discus, Clinical Trials, and International Clinical Trials Registry Platform. The applied search terms were upper limb, activity tracking, and functional activity. Studies were included when they reported the accuracy and/or validity results of accelerometer-based methods to describe upper limb functional use.

Results and significance

13 studies were included describing counts threshold analyzing methods, gross movement scores and machine learning models. Seven studies retrieved a medium score, and six received a low-quality score on the quality assessment scale. The classification accuracy of the machine learning models ranged from 68 % to 97 % for intrasubject accuracy and from 59 % to 92 % for intersubject accuracy, compared to video annotated data. Besides good accuracy scores, the machine learning models also retrieved high validity results. High accuracy results were furthermore retrieved for the counts threshold method. Based on the evaluated studies, objectively assessing upper limb functional use can be done accurately and valid using accelerometry and can be an added value to assess upper limb dysfunctions in daily clinical practice.

背景：上肢功能障碍是日常生活中常见的致残性疾病。加速度计数据通常用于描述上肢的使用情况。然而，不同的数据分析方法用于描述或分类上肢的使用情况：本系统综述旨在概述使用加速度计的评估和数据分析方法，并明确其评估上肢功能使用的准确性和有效性：在以下数据库中进行了系统的文献检索：方法：通过以下数据库进行了系统性文献检索：Pubmed、Embase、Scopus、Web of Science、Sport Discus、Clinical Trials 和 International Clinical Trials Registry Platform。搜索关键词为上肢、活动追踪和功能活动。结果与意义：13 项研究介绍了计数阈值分析方法、总运动评分和机器学习模型。在质量评估量表中，7 项研究获得了中等评分，6 项研究获得了低质量评分。与视频注释数据相比，机器学习模型的受试者内分类准确率为 68% 至 97%，受试者间分类准确率为 59% 至 92%。除了准确率高之外，机器学习模型还获得了较高的有效性结果。此外，计数阈值法也获得了较高的准确度。根据所评估的研究结果，使用加速度计可以准确有效地客观评估上肢功能的使用情况，并为日常临床实践中评估上肢功能障碍提供附加价值。

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引用次数: 0

An augmented reality dual-task intervention improves postural stability in individuals with Parkinson’s disease 增强现实双任务干预改善了帕金森病患者的姿势稳定性。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-11-14 DOI: 10.1016/j.gaitpost.2024.11.007

Anson B. Rosenfeldt , Matthew C. Streicher , Ryan D. Kaya , Amanda L. Penko , Eric M. Zimmerman , James Y. Liao , Benjamin L. Walter , Jay L. Alberts

Background

The Dual-task Augmented Reality Treatment (DART) trial recently established that dual-task training (DTT) delivered by a physical therapist or the augmented reality DART platform was effective in improving spatiotemporal gait parameters under single- and dual-task conditions in individuals with Parkinson’s disease (PD). Data regarding postural stability were not reported in the primary outcome manuscript.

Objective

The aim of this secondary analysis was to compare the effects of a Traditional DTT intervention delivered by a physical therapist and DTT delivered by the DART platform on postural stability, functional mobility, and turning in individuals with PD. It was hypothesized that both groups would experience similar improvements.

Methods

Forty-seven individuals with PD were randomized to an 8-week (16 sessions) Traditional DTT or DART intervention. The limits of stability test and the instrumented Timed Up and Go (TUG) under single- and dual-task conditions were gathered at Baseline, End of Treatment (EOT), and 8-weeks after EOT.

Results

At EOT, the Traditional DTT and DART groups experienced a 9 % and 14 % improvement in maximal excursion area and a 7 % and 12 % improvement in total TUG time under dual-task conditions, respectively (p<0.05). Turn duration and average and peak turn velocity during the TUG improved for both groups under single- and dual-task conditions at EOT. Improvements in turn duration (dual-task) and average turn velocity (single- and dual-task) persisted 8-weeks after intervention cessation.

Conclusion

Improvements in postural stability, functional mobility, and turning under single- and dual-task conditions following traditional and DART DTT in individuals with PD indicate that cognitive-motor training can be used to effectively treat postural instability in this population. Improvements in the DART group were similar to traditional DTT, supporting our previous data demontrating that DART is an effective digital therapeutic to improve gait and postural instability in individuals with PD.

背景：双任务增强现实治疗（DART）试验最近证实，由物理治疗师或增强现实DART平台提供的双任务训练（DTT）能有效改善帕金森病（PD）患者在单任务和双任务条件下的时空步态参数。主要结果手稿中未报告有关姿势稳定性的数据：本二次分析旨在比较物理治疗师提供的传统 DTT 干预与 DART 平台提供的 DTT 对帕金森病患者姿势稳定性、功能移动性和转身的影响。假设两组患者的改善效果相似：47名帕金森氏症患者被随机分配到为期8周（16次）的传统DTT或DART干预中。分别在基线、治疗结束（EOT）和治疗结束后 8 周收集单任务和双任务条件下的稳定性极限测试和仪器定时上下楼（TUG）测试结果：结果：在治疗结束（EOT）时，传统 DTT 组和 DART 组的最大偏移面积分别提高了 9% 和 14%，双任务条件下的总 TUG 时间分别提高了 7% 和 12%（p 结论：帕金森氏症患者在接受传统和DART DTT训练后，在单任务和双任务条件下的姿势稳定性、功能移动性和翻身能力均有所提高，这表明认知运动训练可用于有效治疗该人群的姿势不稳定性。DART 组的改善效果与传统 DTT 相似，支持了我们之前的数据，证明 DART 是改善步态和姿势不稳定性的有效数字疗法。

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引用次数: 0