Which Lower Limb Frontal Plane Sensory and Motor Functions Predict Gait Speed and Efficiency on Uneven Surfaces in Older Persons With Diabetic Neuropathy?
Which Lower Limb Frontal Plane Sensory and Motor Functions Predict Gait Speed and Efficiency on Uneven Surfaces in Older Persons With Diabetic Neuropathy?
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DOI：
10.1016/j.pmrj.2012.05.002
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发表时间：
2012-10-01
期刊：
影响因子：
2.1
通讯作者：
Richardson, James K.
中科院分区：
文献类型：
--
作者：
Allet, Lara;Kim, Hogene;Richardson, James K.
目的：确定哪个额状面下肢感觉运动功能预测步态速度和效率设计：横断面观察性研究。地点：生物力学研究实验室。参与者：33名受试者（14名妇女[42.4%]; 21例糖尿病远端对称性周围神经病变[63.6%]），从正常到明显的糖尿病神经病变的下肢感觉运动功能谱。自变量包括踝关节内翻-外翻本体感受阈值，以及髋关节外展-内收和踝关节内翻-外翻的最大随意力量和最大扭矩发展率（RTD）的标准化测量。运动学数据通过使用光电系统作为受试者走过一个不平坦的10米的表面。主要结果Measures：因变量包括步态速度和效率（由步宽步长比确定）在不平坦的表面。结果：髋内收RTD和踝关节内翻RTD预测54%的步态速度，前者预测的大多数（44%）。踝关节内翻RTD是步态效率的唯一重要预测因子，占其变异性的46%。年龄并没有预测步态速度或efficiency.Conclusions：在额状面的力量在髋关节和踝关节的快速生成负责在老年人的不规则表面的成功谈判。年龄没有表现出独立的影响。老年人的训练方案应包括快速发展髋内收肌和踝内翻肌力量的动作，如果不平坦表面的导航是一个功能性目标。PM R 2012;4：726-733
Objective: To identify which frontal plane lower limb sensorimotor functions predict gait speed and efficiency (step-width-to-step-length ratio) on an uneven surface.Design: Cross-sectional observational study.Setting: A biomechanics research laboratory.Participants: Thirty-three subjects (14 women [42.4%]; 21 with diabetic distal symmetric peripheral neuropathy [63.6%]), with a spectrum of lower limb sensorimotor functions that ranged from normal to marked diabetic neuropathy.Methods: Independent variables included ankle inversion-eversion proprioceptive thresholds, and normalized measures of maximum voluntary strength and maximum rate of torque development (RTD) of hip abduction-adduction and ankle inversion-eversion. Kinematic data were obtained by using an optoelectronic system as subjects walked over an uneven 10-m surface.Main Outcome Measures: Dependent variables included gait speed and efficiency (determined by step-width-to-step-length ratio) on an uneven surface.Results: Hip adduction RTD and ankle inversion RTD predicted 54% of gait speed, with the former predicting the majority (44%). Ankle inversion RTD was the only significant predictor of gait efficiency, which accounted for 46% of its variability. Age did not predict gait speed or efficiency.Conclusions: The rapid generation of strength in the frontal plane at the hip and ankle is responsible for the successful negotiation of irregular surfaces in older persons. Age demonstrated no independent influence. Training regimens in older persons should include maneuvers that rapidly develop strength in hip adductors and ankle invertors if navigation of uneven surfaces is a functional goal. PM R 2012;4:726-733