Gait & posture最新文献_第4页

Effects of 30-min of walking on knee total joint moment asymmetry in asymptomatic adults 步行30分钟对无症状成人膝关节总关节力矩不对称的影响。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-15 DOI: 10.1016/j.gaitpost.2025.110056

Carson Halliwell , Meaghan Hannigan , Ryan Matthews , Anne Doan , Rose MacLeod , Rebecca Moyer

Introduction

Gait asymmetry is considered an indicator of healthy gait and used in clinical and research settings to assess movement. While walking is commonly prescribed to promote cardiovascular health and assess gait under controlled conditions, prolonged walking may disrupt gait asymmetry. This study examined changes in knee total joint moment (TJM) asymmetry following a 30-min treadmill walk in asymptomatic adults.

Methods

Participants completed five overground walking trials at a self-selected speed before and after a 30-min treadmill walk. Three-dimensional motion capture and ground reaction forces were used to calculate knee joint moments. The TJM was calculated as a composite measure of the net external knee frontal, sagittal, and transverse moments, and absolute inter-limb asymmetry in the TJM was calculated. Paired samples t-tests and 95 % bootstrapped confidence intervals were used to assess the expected change in TJM asymmetry following the 30-min walk. Statistical parametric mapping assessed differences in knee frontal, sagittal and transverse plane moments before and after the treadmill walk.

Results

Twenty-one asymptomatic adults (age 61 ± 10 years, 14 F/7 M) were recruited for this study. Following the treadmill walk TJM asymmetry increased by 10.1 % (95 %CI: 4.88–16.1, p = 0.005, d=0.73), with 76 % of participants increasing asymmetry post-walk driven primarily by an increase in the peak frontal plane moment (p = 0.013).

Conclusions

This study provides a benchmark for clinicians and researchers to gauge the expected change in TJM asymmetry in healthy adults following a 30-min walking intervention. We observed that asymmetry increases by approximately 5–16 % in this population; however, high inter-individual variability was noted.

步态不对称被认为是健康步态的一个指标，并在临床和研究环境中用于评估运动。虽然步行通常被用于促进心血管健康和在受控条件下评估步态，但长时间步行可能会破坏步态不对称。本研究检查了无症状成人在30分钟的跑步机步行后膝关节总关节力矩（TJM）不对称性的变化。方法：参与者在跑步机行走30分钟之前和之后，以自己选择的速度完成五次地上行走试验。采用三维运动捕捉和地面反作用力计算膝关节力矩。TJM是由膝外净额、矢状和横向力矩的综合测量来计算的，并计算TJM的绝对肢间不对称性。配对样本t检验和95% %自举置信区间用于评估步行30分钟后TJM不对称性的预期变化。统计参数映射评估了跑步机行走前后膝关节额、矢状面和横切面的差异。结果：21名无症状成人（年龄61 ± 10岁，14 F/7 M）被纳入本研究。在跑步机步行后，TJM不对称性增加了10.1 %(95 %CI: 4.88-16.1, p = 0.005,d=0.73)， 76 %的参与者在步行后增加了不对称性，主要是由于额平面峰值矩的增加（p = 0.013）。结论：本研究为临床医生和研究人员提供了一个基准，以衡量健康成人在30分钟步行干预后TJM不对称的预期变化。我们观察到，在这个人群中，不对称性增加了大约5- 16% %；然而，注意到高度的个体间差异。

{"title":"Effects of 30-min of walking on knee total joint moment asymmetry in asymptomatic adults","authors":"Carson Halliwell , Meaghan Hannigan , Ryan Matthews , Anne Doan , Rose MacLeod , Rebecca Moyer","doi":"10.1016/j.gaitpost.2025.110056","DOIUrl":"10.1016/j.gaitpost.2025.110056","url":null,"abstract":"<div><h3>Introduction</h3><div>Gait asymmetry is considered an indicator of healthy gait and used in clinical and research settings to assess movement. While walking is commonly prescribed to promote cardiovascular health and assess gait under controlled conditions, prolonged walking may disrupt gait asymmetry. This study examined changes in knee total joint moment (TJM) asymmetry following a 30-min treadmill walk in asymptomatic adults.</div></div><div><h3>Methods</h3><div>Participants completed five overground walking trials at a self-selected speed before and after a 30-min treadmill walk. Three-dimensional motion capture and ground reaction forces were used to calculate knee joint moments. The TJM was calculated as a composite measure of the net external knee frontal, sagittal, and transverse moments, and absolute inter-limb asymmetry in the TJM was calculated. Paired samples t-tests and 95 % bootstrapped confidence intervals were used to assess the expected change in TJM asymmetry following the 30-min walk. Statistical parametric mapping assessed differences in knee frontal, sagittal and transverse plane moments before and after the treadmill walk.</div></div><div><h3>Results</h3><div>Twenty-one asymptomatic adults (age 61 ± 10 years, 14 F/7 M) were recruited for this study. Following the treadmill walk TJM asymmetry increased by 10.1 % (95 %CI: 4.88–16.1, p = 0.005, d=0.73), with 76 % of participants increasing asymmetry post-walk driven primarily by an increase in the peak frontal plane moment (p = 0.013).</div></div><div><h3>Conclusions</h3><div>This study provides a benchmark for clinicians and researchers to gauge the expected change in TJM asymmetry in healthy adults following a 30-min walking intervention. We observed that asymmetry increases by approximately 5–16 % in this population; however, high inter-individual variability was noted.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110056"},"PeriodicalIF":2.4,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566747","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

Changes in lower extremity kinematics with free and restricted arm swings in children with unilateral cerebral palsy 单侧脑瘫患儿自由和受限手臂摆动对下肢运动学的影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-13 DOI: 10.1016/j.gaitpost.2025.110047

İlker Abdullah Sarıkaya , Meltem Çelik , Osman Doğan , Barış Görgün , Ozan Ali Erdal , Muharrem İnan

Background

Children with unilateral cerebral palsy (UCP) often exhibit asymmetry, which significantly impacts gait function. Arm swing plays a crucial role in gait mechanics and asymmetric arm movements are hypothesized to influence lower extremity kinematics.

Research Question

How does restricting arm swing in children with unilateral cerebral palsy affect the kinematic parameters of lower extremity?

Methods

A prospective cohort study was conducted with 19 children aged 5–18, diagnosed with UCP, who were able to walk independently. Participants underwent 3D gait analysis under four conditions: no arm restriction (NAR), healthy arm restricted (HAR), affected arm restricted (AAR), and both arms restricted (BAR). Comparative analysis was conducted using the Friedman Test and multiple pairwise comparisons with bootstrapping.

Results

Pelvic rotation and obliquity showed significant improvements with HAR compared to NAR, with the pelvis moving closer to neutral alignment. Knee flexion during the swing phase increased with BAR, addressing a common deficit in UCP patients. Ankle dorsiflexion improved with both arm restrictions but remained impaired with only HAR.

Conclusion

In conclusion, arm restriction has an influence on lower extremity gait kinematic in children with UCP. Restriction of the unaffected arm movement has a corrective effect on pelvic kinematics. Similarly, restricting both arms improve swing phase knee flexion. These results can be useful for gait rehabilitation strategies of UCP children.

背景：单侧脑瘫（UCP）患儿经常表现出不对称性，这严重影响了步态功能。手臂摆动在步态力学中起着至关重要的作用，不对称手臂运动被假设会影响下肢运动学。研究问题：限制单侧脑瘫患儿手臂摆动对其下肢运动参数有何影响？方法采用前瞻性队列研究方法，对19例5-18岁诊断为UCP且能独立行走的儿童进行研究。参与者在四种情况下进行了3D步态分析：无手臂限制（NAR）、健康手臂限制（HAR）、受影响的手臂限制（AAR）和双臂限制（BAR）。比较分析采用Friedman检验和多重两两比较与bootstrapping。结果与NAR相比，HAR的骨盆旋转和倾斜度有显著改善，骨盆更接近中性对齐。随着BAR的增加，摆动阶段的膝关节屈曲度增加，解决了UCP患者的常见缺陷。踝关节背屈在双臂限制时得到改善，但仅HAR时仍然受损。结论手臂限制对UCP患儿下肢步态运动学有影响。限制未受影响的手臂运动对骨盆运动学有矫正作用。同样，限制双臂可以改善摆动阶段的膝关节屈曲。这些结果可以为UCP儿童的步态康复策略提供参考。

{"title":"Changes in lower extremity kinematics with free and restricted arm swings in children with unilateral cerebral palsy","authors":"İlker Abdullah Sarıkaya , Meltem Çelik , Osman Doğan , Barış Görgün , Ozan Ali Erdal , Muharrem İnan","doi":"10.1016/j.gaitpost.2025.110047","DOIUrl":"10.1016/j.gaitpost.2025.110047","url":null,"abstract":"<div><h3>Background</h3><div>Children with unilateral cerebral palsy (UCP) often exhibit asymmetry, which significantly impacts gait function. Arm swing plays a crucial role in gait mechanics and asymmetric arm movements are hypothesized to influence lower extremity kinematics.</div></div><div><h3>Research Question</h3><div>How does restricting arm swing in children with unilateral cerebral palsy affect the kinematic parameters of lower extremity?</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted with 19 children aged 5–18, diagnosed with UCP, who were able to walk independently. Participants underwent 3D gait analysis under four conditions: no arm restriction (NAR), healthy arm restricted (HAR), affected arm restricted (AAR), and both arms restricted (BAR). Comparative analysis was conducted using the Friedman Test and multiple pairwise comparisons with bootstrapping.</div></div><div><h3>Results</h3><div>Pelvic rotation and obliquity showed significant improvements with HAR compared to NAR, with the pelvis moving closer to neutral alignment. Knee flexion during the swing phase increased with BAR, addressing a common deficit in UCP patients. Ankle dorsiflexion improved with both arm restrictions but remained impaired with only HAR.</div></div><div><h3>Conclusion</h3><div>In conclusion, arm restriction has an influence on lower extremity gait kinematic in children with UCP. Restriction of the unaffected arm movement has a corrective effect on pelvic kinematics. Similarly, restricting both arms improve swing phase knee flexion. These results can be useful for gait rehabilitation strategies of UCP children.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110047"},"PeriodicalIF":2.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569877","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

Psychometric properties of instrumented tools and outcome measures to assess dynamic, anticipatory and reactive balance in older adults: A scoping review 评估老年人动态、预期和反应性平衡的仪器工具和结果测量的心理测量特性：范围综述

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-13 DOI: 10.1016/j.gaitpost.2025.110054

Alison M. Bulow , Alison R. Oates , Faith Olarinde , Jonathan C. Singer , Karen Van Ooteghem , Kathryn M. Sibley

Background

Many technologies are available to assess balance; however, there is not one comprehensive option that meets all requirements for each component of balance.

Objective

To identify what instrumented measurement tools and subsequent outcome measures have been established to quantify dynamic, anticipatory, and reactive balance in adults ≥ 65 years old.

Methods

MEDLINE, EMBASE, and CINAHL databases were searched for studies published in English that evaluated one or more psychometric property of instrumented measurement tools and outcome measures to assess dynamic, anticipatory, or reactive balance in adults ≥ 65 years old. Data extraction included participant characteristics, balance component(s), instrumented measurement tools and outcome measures, and psychometric analyses.

Results

Twenty-five studies were included. IMUs are the most commonly reported instrumented measurement tool used to assess anticipatory postural control and dynamic stability while force plates have also been established as valid and reliable for assessing all three components of balance. Test-retest validity and criterion reliability have been established to assess anticipatory postural control and dynamic balance using six outcome measure via IMUs (n = 4) and force plates (n = 2). Reactive postural control was assessed using two outcome measures via force plates.

Significance

Minimal valid and reliable instrumented measurement tools and outcome measures were identified for anticipatory postural control and dynamic stability, and even fewer for reactive postural control. Additional work is needed to establish evidence-based guidance for selecting an instrumented measurement tool and outcome measure(s) to evaluate dynamic, anticipatory, and reactive balance control to appropriately develop and progress balance exercises in community fall prevention programs.

有许多技术可用于评估平衡；然而，没有一个全面的选项可以满足平衡的每个组成部分的所有要求。目的确定已建立的仪器测量工具和随后的结果测量来量化≥ 65岁成人的动态、预期和反应性平衡。方法检索medline、EMBASE和CINAHL数据库中发表的英文研究，这些研究评估了仪器测量工具和结果测量的一种或多种心理测量特性，以评估≥ 65岁成人的动态、预期或反应性平衡。数据提取包括参与者特征、平衡成分、仪器测量工具和结果测量以及心理测量分析。结果共纳入25项研究。imu是最常用的仪器测量工具，用于评估预期姿势控制和动态稳定性，而力板也被确定为评估平衡的所有三个组成部分的有效和可靠的工具。通过imu （n = 4）和力板（n = 2）的六项结果测量，建立了测试重测效度和标准信度来评估预期姿势控制和动态平衡。反应性姿势控制通过力板两种结果测量进行评估。对于预期姿势控制和动态稳定性，有效可靠的仪器测量工具和结果测量方法很少，而对于反应性姿势控制则更少。需要进一步的工作来建立基于证据的指导，以选择仪器测量工具和结果测量来评估动态、预期和反应性平衡控制，以适当地发展和推进社区预防跌倒项目中的平衡练习。

{"title":"Psychometric properties of instrumented tools and outcome measures to assess dynamic, anticipatory and reactive balance in older adults: A scoping review","authors":"Alison M. Bulow , Alison R. Oates , Faith Olarinde , Jonathan C. Singer , Karen Van Ooteghem , Kathryn M. Sibley","doi":"10.1016/j.gaitpost.2025.110054","DOIUrl":"10.1016/j.gaitpost.2025.110054","url":null,"abstract":"<div><h3>Background</h3><div>Many technologies are available to assess balance; however, there is not one comprehensive option that meets all requirements for each component of balance.</div></div><div><h3>Objective</h3><div>To identify what instrumented measurement tools and subsequent outcome measures have been established to quantify dynamic, anticipatory, and reactive balance in adults ≥ 65 years old.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE, and CINAHL databases were searched for studies published in English that evaluated one or more psychometric property of instrumented measurement tools and outcome measures to assess dynamic, anticipatory, or reactive balance in adults ≥ 65 years old. Data extraction included participant characteristics, balance component(s), instrumented measurement tools and outcome measures, and psychometric analyses.</div></div><div><h3>Results</h3><div>Twenty-five studies were included. IMUs are the most commonly reported instrumented measurement tool used to assess anticipatory postural control and dynamic stability while force plates have also been established as valid and reliable for assessing all three components of balance. Test-retest validity and criterion reliability have been established to assess anticipatory postural control and dynamic balance using six outcome measure via IMUs (n = 4) and force plates (n = 2). Reactive postural control was assessed using two outcome measures via force plates.</div></div><div><h3>Significance</h3><div>Minimal valid and reliable instrumented measurement tools and outcome measures were identified for anticipatory postural control and dynamic stability, and even fewer for reactive postural control. Additional work is needed to establish evidence-based guidance for selecting an instrumented measurement tool and outcome measure(s) to evaluate dynamic, anticipatory, and reactive balance control to appropriately develop and progress balance exercises in community fall prevention programs.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110054"},"PeriodicalIF":2.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518147","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

Commentary on “Analysis of dynamic balance in preschool children through the balance beam test: A cross-sectional study providing reference values” 评《通过平衡木试验分析学龄前儿童的动平衡：一项具有参考价值的横断面研究》

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-13 DOI: 10.1016/j.gaitpost.2025.110053

Ruqiang Liu, Shili Zhao

引用次数: 0

Robot-assisted gait training for lower limb motor recovery in cerebral palsy: A meta-analysis of combined and standalone approaches 机器人辅助步态训练用于脑瘫患者下肢运动恢复：联合和独立方法的荟萃分析。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-12 DOI: 10.1016/j.gaitpost.2025.110052

HongJie Chen , GuoJun Yun , JingGang Wang , YanPing Fan , WeiDong Zhao , YuJun Zhan , Shuo Sun , YaTing Wang

Background

Cerebral palsy (CP), a leading cause of childhood motor disability, severely impacts lower limb function. Conventional gait training (CGT) faces challenges in standardization, while robot-assisted gait training (RAGT) offers biomechanical consistency but conflicting efficacy evidence. This meta-analysis evaluates RAGT monotherapy versus combined RAGT+CGT, therapeutic dose, and exoskeleton treadmill versus wearable robotic systems.

Methods

A systematic search across seven databases identified 19 randomized controlled trials (n = 1129). Outcomes included Gross Motor Function Measure-88 (GMFM-88) domains D/E, Berg Balance Scale (BBS), 6-minute walk test (6MWT), walking speed, and Modified Ashworth Scale (MAS). Subgroup analyses assessed therapeutic dose and robot type. Random- and fixed-effects models were applied.

Results

Combined RAGT+CGT significantly outperformed RAGT alone and CGT in GMFM-D [MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00),P < 0.00001], BBS [MD= 6.15,95 %CI(4.81,7.48) vs. 2.45,95 %CI(0.94,3.96),P < 0.00001], 6MWT [MD= 41.35,95 %CI(17.65,65.06) vs. 21.50,95 %CI(12.67,30.33),P = 0.0006],Walking speed [MD= 5.69,95 %CI(0.75,10.63) vs. 0.98,95 %CI(-0.78,2.75),P = 0.02] and MAS [MD= -0.37,95 %CI(-0.63,-0.12) vs. 0.19,95 %CI(-0.27,0.65),P = 0.004]. Low-to-medium dose interventions (1000–4000 min) achieved superior gains in GMFM-D/E compared to long-term protocols. Exoskeleton treadmills (e.g., Lokomat) outperformed wearable devices in GMFM-D/E improvements. Heterogeneity was moderate-to-high (I²=69–88 %), but sensitivity analyses confirmed robustness.

Conclusions

Combined RAGT and conventional rehabilitation significantly enhances lower limb motor function, balance, walking endurance/speed, and reduces spasticity in children with CP compared to RAGT alone (excluding GMFM-E). Medium-term interventions (8 weeks;dose:1000–4000 min) using exoskeleton treadmills yield superior outcomes to both extended protocols (>8 weeks;>4000 min) and wearable devices. Standardized assessments are needed to clarify GMFM-E improvements.

背景：脑瘫（CP）是儿童运动障碍的主要原因，严重影响下肢功能。传统的步态训练（CGT）在标准化方面面临挑战，而机器人辅助步态训练（RAGT）在生物力学方面具有一致性，但疗效证据相互矛盾。这项荟萃分析评估了RAGT单药治疗与RAGT+CGT联合治疗、治疗剂量、外骨骼跑步机与可穿戴机器人系统。方法：系统检索7个数据库，确定19个随机对照试验（n = 1129）。结果包括大运动功能测量-88 (GMFM-88) D/E域、Berg平衡量表（BBS）、6分钟步行测试（6MWT）、步行速度和改良Ashworth量表（MAS）。亚组分析评估治疗剂量和机器人类型。采用随机效应和固定效应模型。结果：RAGT+CGT联合治疗在gmmf - d方面的疗效显著优于RAGT单独治疗和CGT治疗[MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00)，P 结论：与RAGT单独治疗相比，RAGT联合常规康复治疗可显著增强CP患儿下肢运动功能、平衡、步行耐力/速度，并减少痉挛（不包括gmmf - e）。使用外骨骼跑步机的中期干预（8周；剂量：1000-4000 min）比扩展方案（>8周；>4000 min）和可穿戴设备的效果都要好。需要进行标准化评估，以明确转基因食品- e的改进。

{"title":"Robot-assisted gait training for lower limb motor recovery in cerebral palsy: A meta-analysis of combined and standalone approaches","authors":"HongJie Chen , GuoJun Yun , JingGang Wang , YanPing Fan , WeiDong Zhao , YuJun Zhan , Shuo Sun , YaTing Wang","doi":"10.1016/j.gaitpost.2025.110052","DOIUrl":"10.1016/j.gaitpost.2025.110052","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy (CP), a leading cause of childhood motor disability, severely impacts lower limb function. Conventional gait training (CGT) faces challenges in standardization, while robot-assisted gait training (RAGT) offers biomechanical consistency but conflicting efficacy evidence. This meta-analysis evaluates RAGT monotherapy versus combined RAGT+CGT, therapeutic dose, and exoskeleton treadmill versus wearable robotic systems.</div></div><div><h3>Methods</h3><div>A systematic search across seven databases identified 19 randomized controlled trials (n = 1129). Outcomes included Gross Motor Function Measure-88 (GMFM-88) domains D/E, Berg Balance Scale (BBS), 6-minute walk test (6MWT), walking speed, and Modified Ashworth Scale (MAS). Subgroup analyses assessed therapeutic dose and robot type. Random- and fixed-effects models were applied.</div></div><div><h3>Results</h3><div>Combined RAGT+CGT significantly outperformed RAGT alone and CGT in GMFM-D [MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00),P < 0.00001], BBS [MD= 6.15,95 %CI(4.81,7.48) vs. 2.45,95 %CI(0.94,3.96),P < 0.00001], 6MWT [MD= 41.35,95 %CI(17.65,65.06) vs. 21.50,95 %CI(12.67,30.33),P = 0.0006],Walking speed [MD= 5.69,95 %CI(0.75,10.63) vs. 0.98,95 %CI(-0.78,2.75),P = 0.02] and MAS [MD= -0.37,95 %CI(-0.63,-0.12) vs. 0.19,95 %CI(-0.27,0.65),P = 0.004]. Low-to-medium dose interventions (1000–4000 min) achieved superior gains in GMFM-D/E compared to long-term protocols. Exoskeleton treadmills (e.g., Lokomat) outperformed wearable devices in GMFM-D/E improvements. Heterogeneity was moderate-to-high (I²=69–88 %), but sensitivity analyses confirmed robustness.</div></div><div><h3>Conclusions</h3><div>Combined RAGT and conventional rehabilitation significantly enhances lower limb motor function, balance, walking endurance/speed, and reduces spasticity in children with CP compared to RAGT alone (excluding GMFM-E). Medium-term interventions (8 weeks;dose:1000–4000 min) using exoskeleton treadmills yield superior outcomes to both extended protocols (>8 weeks;>4000 min) and wearable devices. Standardized assessments are needed to clarify GMFM-E improvements.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110052"},"PeriodicalIF":2.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552516","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

Same patients, different professionals: A comparative study of Edinburgh Visual Gait Scorring accuracy and agreement in cerebral palsy 相同的患者，不同的专业人员：脑瘫患者爱丁堡视觉步态评分准确性和一致性的比较研究

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-12 DOI: 10.1016/j.gaitpost.2025.110051

Sema Ertan Birsel , Meltem Celik , Osman Dogan , Elif Demirci , Onur Oto , Recep Abdullah Erten , Muharrem Inan

Background

Accurate gait assessment in cerebral palsy (CP) is essential for determining treatment strategies. The Edinburgh Visual Gait Score (EVGS) provides a standardized framework for assessing gait deviations visually. However, inter-observer variability between surgeons and physiotherapists may impact the agreement in assessment and decision-making in CP.

Research question

Do pediatric orthopedic surgeons and physiotherapists differ in their scoring accuracy and inter-rater reliability when using the Edinburgh Visual Gait Score to assess gait in children with cerebral palsy?

Methods

This study was conducted among physiotherapists and pediatric orthopedic surgeons who had the same gait assessment training. The gait data of 10 children and the standardized EVGS scoring form were shared with professionals via email. The collected data were analyzed to evaluate both inter-professional agreement between the groups and intragroup consistency within each group and the accuracy level for each group.

Results

21 physiotherapists and 15 pediatric orthopedic surgeons participated in this study. The overall accuracy of the total EVGS was 55.5 % for pediatric orthopedic surgeons, and 48.3 % for physiotherapists. Pediatric orthopedic surgeons exhibited high-moderate agreement (Krippendorff’s Alpha coefficients over 0.70) for parameters of distal segments (foot and knee). However, intragroup reliability for pelvic and hip parameters showed lower agreement with Krippendorff’s Alpha coefficients below 0.70. Physiotherapists demonstrated "low agreement" for all items and the total score, with Krippendorff’s Alpha values below 0.67.

Significance

Current study findings reinforce the importance of continued education and practice in maximizing the clinical and research potential of the EVGS. While variability persists between professional groups, the EVGS remains a valid and valuable tool for evaluating gait in CP.

背景：脑瘫患者准确的步态评估对于确定治疗策略至关重要。爱丁堡视觉步态评分（EVGS）为视觉评估步态偏差提供了一个标准化的框架。然而，外科医生和物理治疗师之间的观察者间差异可能会影响cp评估和决策的一致性。研究问题：在使用爱丁堡视觉步态评分评估脑瘫儿童的步态时，儿科骨科医生和物理治疗师在评分准确性和评估者间可靠性方面存在差异吗？方法本研究在接受过相同步态评估训练的物理治疗师和儿科骨科医生中进行。10名儿童的步态数据和标准化EVGS计分表通过电子邮件与专业人员共享。对收集到的数据进行分析，以评估各组之间的专业间一致性和各组内部一致性以及各组的准确性水平。结果21名物理治疗师和15名儿科骨科医生参与了本研究。儿童骨科医生EVGS的总体准确率为55.5% %，物理治疗师为48.3% %。小儿骨科医生对远端节段（足和膝关节）的参数表现出中高一致性（Krippendorff 's Alpha系数大于0.70）。然而，骨盆和髋关节参数的组内信度与Krippendorff Alpha系数低于0.70的一致性较低。物理治疗师对所有项目和总分表现出“低一致性”，Krippendorff的Alpha值低于0.67。目前的研究结果强调了继续教育和实践在最大限度地发挥EVGS临床和研究潜力方面的重要性。虽然专业组之间存在差异，但EVGS仍然是评估CP步态的有效和有价值的工具。

{"title":"Same patients, different professionals: A comparative study of Edinburgh Visual Gait Scorring accuracy and agreement in cerebral palsy","authors":"Sema Ertan Birsel , Meltem Celik , Osman Dogan , Elif Demirci , Onur Oto , Recep Abdullah Erten , Muharrem Inan","doi":"10.1016/j.gaitpost.2025.110051","DOIUrl":"10.1016/j.gaitpost.2025.110051","url":null,"abstract":"<div><h3>Background</h3><div>Accurate gait assessment in cerebral palsy (CP) is essential for determining treatment strategies. The Edinburgh Visual Gait Score (EVGS) provides a standardized framework for assessing gait deviations visually. However, inter-observer variability between surgeons and physiotherapists may impact the agreement in assessment and decision-making in CP.</div></div><div><h3>Research question</h3><div>Do pediatric orthopedic surgeons and physiotherapists differ in their scoring accuracy and inter-rater reliability when using the Edinburgh Visual Gait Score to assess gait in children with cerebral palsy?</div></div><div><h3>Methods</h3><div>This study was conducted among physiotherapists and pediatric orthopedic surgeons who had the same gait assessment training. The gait data of 10 children and the standardized EVGS scoring form were shared with professionals via email. The collected data were analyzed to evaluate both inter-professional agreement between the groups and intragroup consistency within each group and the accuracy level for each group.</div></div><div><h3>Results</h3><div>21 physiotherapists and 15 pediatric orthopedic surgeons participated in this study. The overall accuracy of the total EVGS was 55.5 % for pediatric orthopedic surgeons, and 48.3 % for physiotherapists. Pediatric orthopedic surgeons exhibited high-moderate agreement (Krippendorff’s Alpha coefficients over 0.70) for parameters of distal segments (foot and knee). However, intragroup reliability for pelvic and hip parameters showed lower agreement with Krippendorff’s Alpha coefficients below 0.70. Physiotherapists demonstrated \"low agreement\" for all items and the total score, with Krippendorff’s Alpha values below 0.67.</div></div><div><h3>Significance</h3><div>Current study findings reinforce the importance of continued education and practice in maximizing the clinical and research potential of the EVGS. While variability persists between professional groups, the EVGS remains a valid and valuable tool for evaluating gait in CP.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110051"},"PeriodicalIF":2.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569867","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

Lower-extremity kinematics during unanticipated side-cutting including before initial ground contact 在意想不到的侧面切割期间，包括初始地面接触之前的下肢运动学

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-10 DOI: 10.1016/j.gaitpost.2025.110050

Kazunori Okamura , Shoma Uehara , Shusaku Kanai

Background

The biomechanical reasons why lateral ankle sprains (LAS) are more likely to occur during unanticipated side-cutting (UNA-SC) than under anticipated side-cutting (ANT-SC) are unclear.

Research question

Are there differences in lower-extremity kinematics between ANT-SC and UNA-SC that are relevant to LAS incidence?

Methods

This is a cross-sectional study. Twenty-one male soccer players performed a 45° ANT-SC and UNA-SC. Their ankle, knee, and hip joints and foot segment kinematic data, from 0.2 s before initial ground contact (IC) to toe-off, were analyzed using paired t tests of statistical parametric mapping.

Results

In the frontal plane, faster hip abduction and lateral movement of the foot segment before IC and faster ankle inversion immediately afterwards were characteristic of UNA-SC relative to ANT-SC. In the sagittal plane, smaller and slower ankle dorsiflexion and larger and faster knee and hip flexion after IC were also characteristic of UNA-SC.

Significance

In the frontal plane, during UNA-SC, IC with increased lateral velocity of the foot segment, accompanied by immediate, rapid hip abduction, resulted in faster ankle inversion and an increased risk of LAS. Kinematic changes in the sagittal plane suggest that compensatory contributions of the hip and knee joints absorb landing impact and protect the ankle joint under UNA-SC.

背景：外侧踝关节扭伤（LAS）在非预期侧切（UNA-SC）期间比预期侧切（ANT-SC）期间更容易发生的生物力学原因尚不清楚。研究问题ANT-SC和UNA-SC之间的下肢运动学是否存在与LAS发生率相关的差异？方法采用横断面研究。21名男性足球运动员进行了45°ANT-SC和UNA-SC。他们的踝关节、膝关节、髋关节和足部的运动学数据，从最初的地面接触（IC）之前的0.2 s到脚趾，使用统计参数映射的配对t检验进行分析。结果与ANT-SC相比，UNA-SC在前平面髋关节外展和足段外侧运动更快，后即刻踝关节内翻更快。在矢状面，IC后踝关节背屈更小、更慢，膝关节、髋关节屈曲更大、更快也是UNA-SC的特征。在前位面，UNA-SC期间，足段侧移速度增加的IC，伴随着立即、快速的髋关节外展，导致踝关节内翻更快，LAS风险增加。矢状面的运动学变化表明，髋关节和膝关节的代偿性贡献吸收了落地冲击并保护了UNA-SC下的踝关节。

{"title":"Lower-extremity kinematics during unanticipated side-cutting including before initial ground contact","authors":"Kazunori Okamura , Shoma Uehara , Shusaku Kanai","doi":"10.1016/j.gaitpost.2025.110050","DOIUrl":"10.1016/j.gaitpost.2025.110050","url":null,"abstract":"<div><h3>Background</h3><div>The biomechanical reasons why lateral ankle sprains (LAS) are more likely to occur during unanticipated side-cutting (UNA-SC) than under anticipated side-cutting (ANT-SC) are unclear.</div></div><div><h3>Research question</h3><div>Are there differences in lower-extremity kinematics between ANT-SC and UNA-SC that are relevant to LAS incidence?</div></div><div><h3>Methods</h3><div>This is a cross-sectional study. Twenty-one male soccer players performed a 45° ANT-SC and UNA-SC. Their ankle, knee, and hip joints and foot segment kinematic data, from 0.2 s before initial ground contact (IC) to toe-off, were analyzed using paired <em>t</em> tests of statistical parametric mapping.</div></div><div><h3>Results</h3><div>In the frontal plane, faster hip abduction and lateral movement of the foot segment before IC and faster ankle inversion immediately afterwards were characteristic of UNA-SC relative to ANT-SC. In the sagittal plane, smaller and slower ankle dorsiflexion and larger and faster knee and hip flexion after IC were also characteristic of UNA-SC.</div></div><div><h3>Significance</h3><div>In the frontal plane, during UNA-SC, IC with increased lateral velocity of the foot segment, accompanied by immediate, rapid hip abduction, resulted in faster ankle inversion and an increased risk of LAS. Kinematic changes in the sagittal plane suggest that compensatory contributions of the hip and knee joints absorb landing impact and protect the ankle joint under UNA-SC.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110050"},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518149","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

Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review 后退行走作为神经障碍患者的活动能力评估和运动干预：范围综述。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-10 DOI: 10.1016/j.gaitpost.2025.110048

Michael VanNostrand , Patrick G. Monaghan , Wendy Wu , Nora E. Fritz

Objective

Backward walking (BW) has gained increasing attention as a clinically relevant assessment and intervention for individuals with neurological conditions. Given the heterogeneity in how BW has been applied and studied across neurological populations, the objectives of this scoping review were to synthesize the literature related to: 1) the reliability and validity of BW mobility assessments, 2) the utility of BW as a clinical assessment tool, and 3) the efficacy of BW as an exercise intervention.

Data sources

A literature search of six electronic databases and citation searching were conducted through June 9th, 2025. Articles were included in this review if they were peer-reviewed studies involving adults with a central nervous system neurological disorder and met at least one of the following criteria: assessed the reliability or validity of BW, used BW as a clinical assessment tool, or implemented BW as part of an exercise intervention.

Results

Fifty-nine studies were included, examining BW’s reliability/validity (n = 14), use as a clinical assessment (n = 17), and role in interventions (n = 28). BW showed high reliability and moderate-to-strong correlations with established measures, outperformed other assessments in discriminating fall risk and mobility status, and improved gait speed, balance, and postural control when used in interventions.

Conclusion

BW is a reliable, valid marker of mobility and balance that better distinguishes fall risk and mobility status than common assessments and shows promise as an intervention to improve gait, balance, and postural control. However, methodological inconsistencies and limited longitudinal data warrant further research to standardize assessment protocols and optimize intervention strategies.

目的：后退行走（BW）作为一种与神经系统疾病相关的临床评估和干预手段，越来越受到人们的关注。鉴于体重在神经学人群中应用和研究的异质性，本综述的目的是综合以下方面的文献：1)体重流动性评估的可靠性和有效性，2)体重作为临床评估工具的效用，以及3)体重作为运动干预的有效性。数据来源：截至2025年6月9日，对6个电子数据库进行文献检索和引文检索。本综述纳入了同行评议的涉及中枢神经系统神经障碍成人的研究，并至少满足以下标准之一：评估了BW的可靠性或有效性，将BW作为临床评估工具，或将BW作为运动干预的一部分。结果：纳入59项研究，检查体重的信度/效度（n = 14），作为临床评估（n = 17），以及在干预中的作用（n = 28）。BW与已建立的测量方法显示出高可靠性和中强相关性，在区分跌倒风险和活动状态方面优于其他评估，并且在干预中使用时改善了步态速度、平衡和姿势控制。结论：BW是一种可靠、有效的活动和平衡指标，比普通评估更能区分跌倒风险和活动状态，并有望作为改善步态、平衡和姿势控制的干预措施。然而，方法上的不一致性和有限的纵向数据需要进一步研究，以规范评估方案和优化干预策略。

{"title":"Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review","authors":"Michael VanNostrand , Patrick G. Monaghan , Wendy Wu , Nora E. Fritz","doi":"10.1016/j.gaitpost.2025.110048","DOIUrl":"10.1016/j.gaitpost.2025.110048","url":null,"abstract":"<div><h3>Objective</h3><div>Backward walking (BW) has gained increasing attention as a clinically relevant assessment and intervention for individuals with neurological conditions. Given the heterogeneity in how BW has been applied and studied across neurological populations, the objectives of this scoping review were to synthesize the literature related to: 1) the reliability and validity of BW mobility assessments, 2) the utility of BW as a clinical assessment tool, and 3) the efficacy of BW as an exercise intervention.</div></div><div><h3>Data sources</h3><div>A literature search of six electronic databases and citation searching were conducted through June 9th, 2025. Articles were included in this review if they were peer-reviewed studies involving adults with a central nervous system neurological disorder and met at least one of the following criteria: assessed the reliability or validity of BW, used BW as a clinical assessment tool, or implemented BW as part of an exercise intervention.</div></div><div><h3>Results</h3><div>Fifty-nine studies were included, examining BW’s reliability/validity (n = 14), use as a clinical assessment (n = 17), and role in interventions (n = 28). BW showed high reliability and moderate-to-strong correlations with established measures, outperformed other assessments in discriminating fall risk and mobility status, and improved gait speed, balance, and postural control when used in interventions.</div></div><div><h3>Conclusion</h3><div>BW is a reliable, valid marker of mobility and balance that better distinguishes fall risk and mobility status than common assessments and shows promise as an intervention to improve gait, balance, and postural control. However, methodological inconsistencies and limited longitudinal data warrant further research to standardize assessment protocols and optimize intervention strategies.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110048"},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535032","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

Acute effects of dynamic stretching on knee joint position sense and dynamic balance in recreational runners: A randomized controlled trial 动态拉伸对休闲跑步者膝关节位置感和动态平衡的急性影响：一项随机对照试验

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-10 DOI: 10.1016/j.gaitpost.2025.110049

Edgar Simões , Nuno Tavares , Marina Saraiva

Objectives

Proprioception and dynamic balance are crucial elements of neuromuscular control during running, supporting movement precision and postural adjustments. Dynamic stretching is commonly used in warm-ups to enhance muscle activation and sensorimotor readiness, but its acute effects on proprioception and balance remain unclear.

Design

Randomized controlled trial.

Participants

Sixty-two healthy recreational runners (25–45 years; ≥20 km/week), randomly assigned to a Dynamic Stretching group (n = 31) or a control group performing light walking (n = 31).

Main outcome measures

Joint position sense was assessed through active joint repositioning using 2D video analysis, with Absolute Angular Error, Relative Angular Error, and Variable Angular Error as outcomes. Balance was evaluated using the Y-Balance Test, including anterior, posteromedial, and posterolateral reach directions, as well as a composite score.

Results

The Dynamic Stretching group showed significant reductions in Absolute Angular Error (p < 0.05) and Variable Angular Error (p < 0.001), with a between-group difference in Relative Angular Error (p = 0.043). Both groups improved Y-Balance Test scores, but the Dynamic stretching group achieved significantly greater gains in posteromedial reach and Composite Score (p < 0.001).

Conclusions

Dynamic stretching acutely improves proprioceptive accuracy and dynamic balance in recreational runners, supporting its inclusion in warm-up routines.

目的本体感觉和动态平衡是跑步过程中神经肌肉控制的关键要素，支持运动精度和体位调节。动态拉伸通常用于热身，以增强肌肉激活和感觉运动准备，但其对本体感觉和平衡的急性影响尚不清楚。设计随机对照试验。参与者：62名健康的休闲跑步者（25-45岁，≥20 km/week），随机分为动态拉伸组（n = 31）和轻步行组（n = 31）。主要结果测量通过使用二维视频分析主动关节重新定位来评估关节位置感，以绝对角度误差、相对角度误差和可变角度误差作为结果。使用Y-Balance测试评估平衡，包括前、后内侧和后外侧到达方向，以及综合评分。结果动态拉伸组绝对角误差（p < 0.05）和可变角误差（p < 0.001）显著降低，相对角误差组间差异（p = 0.043）。两组均提高了Y-Balance测试分数，但动态拉伸组在内侧后伸和综合得分方面取得了显著更大的进步（p < 0.001）。结论动态拉伸可显著提高休闲跑步者本体感觉的准确性和动态平衡，支持将其纳入热身活动。

{"title":"Acute effects of dynamic stretching on knee joint position sense and dynamic balance in recreational runners: A randomized controlled trial","authors":"Edgar Simões , Nuno Tavares , Marina Saraiva","doi":"10.1016/j.gaitpost.2025.110049","DOIUrl":"10.1016/j.gaitpost.2025.110049","url":null,"abstract":"<div><h3>Objectives</h3><div>Proprioception and dynamic balance are crucial elements of neuromuscular control during running, supporting movement precision and postural adjustments. Dynamic stretching is commonly used in warm-ups to enhance muscle activation and sensorimotor readiness, but its acute effects on proprioception and balance remain unclear.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Participants</h3><div>Sixty-two healthy recreational runners (25–45 years; ≥20 km/week), randomly assigned to a Dynamic Stretching group (n = 31) or a control group performing light walking (n = 31).</div></div><div><h3>Main outcome measures</h3><div>Joint position sense was assessed through active joint repositioning using 2D video analysis, with Absolute Angular Error, Relative Angular Error, and Variable Angular Error as outcomes. Balance was evaluated using the Y-Balance Test, including anterior, posteromedial, and posterolateral reach directions, as well as a composite score.</div></div><div><h3>Results</h3><div>The Dynamic Stretching group showed significant reductions in Absolute Angular Error (p < 0.05) and Variable Angular Error (p < 0.001), with a between-group difference in Relative Angular Error (p = 0.043). Both groups improved Y-Balance Test scores, but the Dynamic stretching group achieved significantly greater gains in posteromedial reach and Composite Score (p < 0.001).</div></div><div><h3>Conclusions</h3><div>Dynamic stretching acutely improves proprioceptive accuracy and dynamic balance in recreational runners, supporting its inclusion in warm-up routines.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110049"},"PeriodicalIF":2.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518148","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

Traumatic unilateral transtibial amputation increases medial-lateral but not anterior-posterior postural sway during quiet stance 外伤性单侧经胫骨截肢增加静站立时的内外侧但不增加前后位摇摆。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-11-08 DOI: 10.1016/j.gaitpost.2025.110029

Moaz Tobaigy , Julie Ferrell-Olson , Brian J. Hafner , Andrew Sawers

Background

Despite notable advances in prosthetic technology, lower-limb prosthesis users continue to experience frequent falls. It remains unclear if and how amputation affects upright balance during quiet stance partly because confounding factors like age, sex, and amputation etiology are often unaccounted for in research studies.

Purpose

Compare postural sway during quiet stance between traumatic unilateral transtibial prosthesis users (TTPU) and unimpaired age- and sex-matched controls.

Methods

Twelve TTPU and 12 age-, sex-matched controls performed three 70-second eyes-open quiet stance trials. Ground reaction forces were measured and used to calculate anterior-posterior (AP) and medial-lateral (ML) center-of-pressure mean velocity (COPmv). A paired Hotelling’s multivariate T² test was used to evaluate differences in net AP and ML COPmv between groups.

Results

A paired Hotelling’s T² test revealed a statistically significant multivariate difference in COPmv between traumatic unilateral TTPUs and matched controls (T² = 3.83, F (2, 10) = 19.15, p = 0.001). Net ML COPmv (TTPU: 1.78 (0.51) mm/s; Controls: 1.21 (0.31) mm/s) was significantly higher in TTPU (t (11) = 3.79, p = 0.003, d = 1.09). Differences in AP COPmv (TTPU: 7.83 (2.57) mm/s; Controls: 6.20 (1.68) mm/s) were not statistically significant (t (11) = 1.77, p = 0.104, d = 0.51).

Significance

Traumatic unilateral TTPU may face greater challenges controlling unperturbed standing balance in the frontal versus sagittal plane. Determining whether these challenges in quiet stance increase susceptibility to perturbations or hinder balance recovery in the frontal plane is an important next step toward addressing balance deficits in TTPUs.

背景：尽管假肢技术取得了显著进步，但下肢假肢使用者仍然经常经历跌倒。目前尚不清楚截肢是否以及如何影响安静站立时的直立平衡，部分原因是研究中往往没有考虑年龄、性别和截肢病因等混杂因素。目的：比较创伤性单侧经胫骨假体使用者（TTPU）和未受损的年龄和性别匹配对照组在安静站立时的姿势摇摆。方法：12名TTPU和12名年龄、性别匹配的对照组进行了3次70秒的睁开眼睛安静站立试验。测量地面反作用力并用于计算前后（AP）和中外侧（ML）压力中心平均速度（COPmv）。采用配对Hotelling’s多变量T2检验评估两组间净AP和ML COPmv的差异。结果：配对Hotelling’s T2检验显示外伤性单侧ttpu与匹配对照组的COPmv差异有统计学意义（T²= 3.83，F(2,10) = 19.15,p = 0.001）。净ML COPmv (TTPU: 1.78 (0.51) mm/s；对照组：TTPU 1.21 (0.31) mm/s显著增高（t(11) = 3.79,p = 0.003,d = 1.09）。AP COPmv (TTPU: 7.83 (2.57) mm/s；对照组：6.20 (1.68)mm/s，差异无统计学意义（t(11) = 1.77,p = 0.104,d = 0.51）。意义：外伤性单侧TTPU在控制额位面与矢状面站立平衡方面可能面临更大的挑战。确定安静姿势的这些挑战是否会增加对扰动的敏感性或阻碍额平面的平衡恢复，是解决ttpu平衡缺陷的重要下一步。

{"title":"Traumatic unilateral transtibial amputation increases medial-lateral but not anterior-posterior postural sway during quiet stance","authors":"Moaz Tobaigy , Julie Ferrell-Olson , Brian J. Hafner , Andrew Sawers","doi":"10.1016/j.gaitpost.2025.110029","DOIUrl":"10.1016/j.gaitpost.2025.110029","url":null,"abstract":"<div><h3>Background</h3><div>Despite notable advances in prosthetic technology, lower-limb prosthesis users continue to experience frequent falls. It remains unclear if and how amputation affects upright balance during quiet stance partly because confounding factors like age, sex, and amputation etiology are often unaccounted for in research studies.</div></div><div><h3>Purpose</h3><div>Compare postural sway during quiet stance between traumatic unilateral transtibial prosthesis users (TTPU) and unimpaired age- and sex-matched controls.</div></div><div><h3>Methods</h3><div>Twelve TTPU and 12 age-, sex-matched controls performed three 70-second eyes-open quiet stance trials. Ground reaction forces were measured and used to calculate anterior-posterior (AP) and medial-lateral (ML) center-of-pressure mean velocity (COPmv). A paired Hotelling’s multivariate T<sup>2</sup> test was used to evaluate differences in net AP and ML COPmv between groups.</div></div><div><h3>Results</h3><div>A paired Hotelling’s T<sup>2</sup> test revealed a statistically significant multivariate difference in COPmv between traumatic unilateral TTPUs and matched controls (<em>T²</em> = 3.83, <em>F</em> (2, 10) = 19.15, <em>p</em> = 0.001). Net ML COPmv (TTPU: 1.78 (0.51) mm/s; Controls: 1.21 (0.31) mm/s) was significantly higher in TTPU (<em>t</em> (11) = 3.79, <em>p</em> = 0.003, <em>d</em> = 1.09). Differences in AP COPmv (TTPU: 7.83 (2.57) mm/s; Controls: 6.20 (1.68) mm/s) were not statistically significant (<em>t</em> (11) = 1.77, <em>p</em> = 0.10<del>4</del>, <em>d</em> = 0.51).</div></div><div><h3>Significance</h3><div>Traumatic unilateral TTPU may face greater challenges controlling unperturbed standing balance in the frontal versus sagittal plane. Determining whether these challenges in quiet stance increase susceptibility to perturbations or hinder balance recovery in the frontal plane is an important next step toward addressing balance deficits in TTPUs.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110029"},"PeriodicalIF":2.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515381","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