Effect of lesion level on the orthotic gait performance in individuals with complete paraplegia
Effect of lesion level on the orthotic gait performance in individuals with complete paraplegia
复制标题
DOI：
10.1038/sj.sc.3101916
复制
发表时间：
2006-08-01
期刊：
影响因子：
2.2
通讯作者：
Akai, M.
中科院分区：
文献类型：
--
作者：
Kawashima, N.;Taguchi, D.;Akai, M.
研究设计：横断面实验研究：目的：阐明损伤水平对脊髓损伤（SCI）完全性截瘫患者使用往复式步态矫形器行走时心肺反应和生物力学特性的影响。设定：日本国立残疾人康复中心。方法：10名SCI患者年龄20-34岁，受伤部位Th 5 -12，至少进行了10周的矫形步态训练，参加两个实验：（1）测定20 min矫形步态训练期间的心肺反应;（2）利用VICON系统进行三维运动分析和地面反力测量。我们计算了以下参数：肺通气量、耗氧量（VO 2）、心率（HR）、步态速度、步频、步长、拐杖力（CF）、髋关节活动范围（ROM）和髋关节角速度（VEL）。此外，能量消耗和能量成本计算使用的VO 2和步态speeds.Results的稳态值的VO 2（18.2 +/- 3.80 ml/kg）和HR（133.0 +/- 21.63 B/min）的稳态值在较高的胸部SCI科目往往是较大的。病变水平与步行速度（r = 0.74）、能量消耗（r = 0.85）和髋关节活动度（r = 0.78）之间存在强正相关。另一方面，病变水平和峰值CF之间的负相关（r = -0.78）被澄清。结论：矫形步态的生理强度强烈依赖于病变的水平。这似乎可能是一个有限的髋关节活动范围和上肢负荷过大的结果在较低的能量成本的矫形步态较高的胸部水平的截瘫患者。
Study design: Cross-sectional, experimental research.Objectives: To clarify the effect of lesion level on cardio-respiratory responses and biomechanical characteristics of walking with a reciprocating gait orthosis in complete paraplegia with spinal cord injury (SCI). Setting: National Rehabilitation Center for Persons with Disabilities, Japan.Methods: Ten SCI individuals (age: 20-34 years, injured level: Th5-12) who experienced orthotic gait training at least for 10 weeks participated in two experiments: (1) measurement of the cardiorespiratory responses during 20 min of orthotic gait exercise; and (2) three-dimensional motion analysis and ground reaction force measurement using the VICON system. We calculated the following parameters: pulmonary ventilation, oxygen consumption (VO2), heart rate (HR), gait speed, cadence, stride length, crutch force (CF), hip range of motion (ROM), and hip angular velocity (VEL). Further, energy consumption and energy cost were calculated using the steady-state value of VO2 and gait speed.Results: The steady-state value of the VO2 (18.2 +/- 3.80 ml/kg) and HR (133.0 +/- 21.63 b/min) tended to be larger in higher thoracic SCI subjects. There were strong positive correlations between the lesion level and walking speed (r = 0.74), energy cost (r = 0.85), and hip ROM (r = 0.78). On the other hand, negative correlation between the lesion level and peak CF (r = -0.78) was clarified.Conclusions: The physiological intensity of the orthotic gait strongly depended on the level of lesion. It seems likely that a limited hip range of motion and excess upper limb load result in the low energy cost of orthotic gait for the higher thoracic level of paraplegic patients.