Muscle contributions to vertical and fore-aft accelerations are altered in subjects with crouch gait
Muscle contributions to vertical and fore-aft accelerations are altered in subjects with crouch gait
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DOI：
10.1016/j.gaitpost.2012.10.019
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发表时间：
2013-05-01
期刊：
影响因子：
2.4
通讯作者：
Delp, Scott L.
中科院分区：
文献类型：
--
作者：
Steele, Katherine M.;Seth, Ajay;Delp, Scott L.
这项研究的目的是确定在蹲姿和未受损步态下，肌肉对重心垂直和前后加速的贡献是否不同，以及这些肌肉贡献是否随着蹲姿的严重程度而改变。检测肌肉对质心加速的作用有助于深入了解个体肌肉在步态中的作用，并可为治疗计划提供指导。我们使用典型发育儿童和脑性瘫痪儿童和蹲姿儿童的肌肉骨骼模拟来计算垂直和前后加速度。对这些模拟的分析表明，在未受损的步态中，股四头肌在站立早期会产生很大的向上和向后加速，而在站立的后期，脚踝拇指屈肌会产生很大的向上和向前加速。相反，在下蹲的步态中，股四头肌和脚踝的足底屈肌在整个站姿过程中会产生巨大的前后相对的加速度。下蹲步态下加速重心向上所需的股四头肌力明显大于未受损伤步态，且随着下蹲步态严重程度的增加而增加。在无损伤步态中，臀中肌加速了重心的向上运动；而在蹲姿时，臀中肌产生的向上加速度明显减小。在不受损伤的步态中，股四头肌和踝趾屈肌在不同的时间加速重心，有效地调节前后的加速度。然而，在蹲姿时，股四头肌和踝屈肌同时产生前后加速度，而这些肌肉产生的相反的前后加速度导致了蹲姿的低效。(C)2012爱思唯尔B.V.保留所有权利。
The goals of this study were to determine if the muscle contributions to vertical and fore-aft acceleration of the mass center differ between crouch gait and unimpaired gait and if these muscle contributions change with crouch severity. Examining muscle contributions to mass center acceleration provides insight into the roles of individual muscles during gait and can provide guidance for treatment planning. We calculated vertical and fore-aft accelerations using musculoskeletal simulations of typically developing children and children with cerebral palsy and crouch gait. Analysis of these simulations revealed that during unimpaired gait the quadriceps produce large upward and backward accelerations during early stance, whereas the ankle plantarflexors produce large upward and forward accelerations later in stance. In contrast, during crouch gait, the quadriceps and ankle plantarflexors produce large, opposing fore-aft accelerations throughout stance. The quadriceps force required to accelerate the mass center upward was significantly larger in crouch gait than in unimpaired gait and increased with crouch severity. The gluteus medius accelerated the mass center upward during midstance in unimpaired gait; however, during crouch gait the upward acceleration produced by the gluteus medius was significantly reduced. During unimpaired gait the quadriceps and ankle plantarflexors accelerate the mass center at different times, efficiently modulating fore-aft accelerations. However, during crouch gait, the quadriceps and ankle plantarflexors produce fore-aft accelerations at the same time and the opposing fore-aft accelerations generated by these muscles contribute to the inefficiency of crouch gait. (C) 2012 Elsevier B. V. All rights reserved.