Reliability of four models for clinical gait analysis
Reliability of four models for clinical gait analysis
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DOI：
10.1016/j.gaitpost.2017.04.001
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发表时间：
2017-05-01
期刊：
影响因子：
2.4
通讯作者：
Carty, Christopher P.
中科院分区：
文献类型：
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作者：
Kainz, Hans;Graham, David;Carty, Christopher P.
三维步态分析(3DGA)已成为脑性瘫痪(CP)患儿治疗计划的常用临床工具。许多临床步态实验室使用传统的步态分析模型(如插入式步态模型)，该模型使用正运动学(DK)进行关节运动学计算，而肌肉骨骼模型主要用于研究，使用反向运动学(IK)。肌肉骨骼IK模型的优势是可以进行额外的分析，这可能会改善患有CP的儿童的临床决策。在任何新的步态模型可以用于临床之前，必须评估其可靠性，并将其与临床上常用的步态模型(例如插入式步态模型)进行比较，这是本研究的目的。两名测试员对11名CP和7名典型发育中的参与者进行了两次3DGA测试。使用测试器内和测试器间的标准差(SD)和测量的标准误差(SEM)来比较两个DK模型(Plug-in-Gait和使用VICON软件求解的六自由度模型)和两个IK模型(使用OpenSim求解对`gait2392‘的两个修改)的可靠性。所有模型均显示出良好的可靠性(所有分析模型和关节角度的平均扫描电子显微镜为3.0度)。在典型的发达人群中，关节动力学的变化比CP参与者要小。改进的tait2392‘模型包含了临床3DGA中常见的所有关节旋转，显示了合理可靠的关节运动学和运动学估计，并允许对手术可调整的参数进行额外的肌肉骨骼分析，例如肌肉-肌腱长度，因此，是一个适合于临床步态分析的模型。
Three-dimensional gait analysis (3DGA) has become a common clinical tool for treatment planning in children with cerebral palsy (CP). Many clinical gait laboratories use the conventional gait analysis model (e.g. Plug-in Gait model), which uses Direct Kinematics (DK) for joint kinematic calculations, whereas, musculoskeletal models, mainly used for research, use Inverse Kinematics (IK). Musculoskeletal IK models have the advantage of enabling additional analyses which might improve the clinical decision-making in children with CP. Before any new model can be used in a clinical setting, its reliability has to be evaluated and compared to a commonly used clinical gait model (e.g. Plug-in-Gait model) which was the purpose of this study. Two testers performed 3DGA in eleven CP and seven typically developing participants on two occasions. Intra- and inter-tester standard deviations (SD) and standard error of measurement (SEM) were used to compare the reliability of two DK models (Plug-in-Gait and a six degrees-of-freedom model solved using Vicon software) and two IK models (two modifications of `gait2392' solved using OpenSim). All models showed good reliability (mean SEM of 3.0 degrees over all analysed models and joint angles). Variations in joint kinetics were less in typically developed than in CP participants. The modified tait2392' model which included all the joint rotations commonly reported in clinical 3DGA, showed reasonable reliable joint kinematic and kinetic estimates, and allows additional musculoskeletal analysis on surgically adjustable parameters, e.g. muscle-tendon lengths, and, therefore, is a suitable model for clinical gait analysis.