Faster walking speeds increase local instability among people with peripheral neuropathy
Faster walking speeds increase local instability among people with peripheral neuropathy
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DOI：
10.1016/j.jbiomech.2008.07.006
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发表时间：
2008-09-18
影响因子：
2.4
通讯作者：
Li, Li
中科院分区：
文献类型：
--
作者：
Manor, Brad;Wolenski, Peter;Li, Li
患有周围神经病变（PN）的个体可以通过降低步行速度来补偿体感的下降。因此，容易跌倒可能是由于无法适应具有挑战性的步行速度。本研究的目的是研究PN对不同速度下步行的变异性和局部不稳定性的影响。12名PN患者和12名对照组完成了6分钟步行测试，以确定快速步行速度（FWS）。然后在100% 80%和60% FWS的跑步机上行走3分钟时计算髋关节和踝关节的矢状面角度。计算步幅持续变异性（SDvar）、关节角度变异性（JTvar）和短期和长期Lyapunov指数（用于估计局部不稳定性）的大小。PN组行走速度慢于对照组（p < 0.001）。两组合并后，步行速度加快导致局部不稳定性增加和变异性增加（p < 0.001）。PN组在所有速度下表现出增加的变异性（SDvar p = 0.02 JTvar p = 0.01），在快速行走时表现出夸大的局部不稳定性（p < 0.05）。PN导致行走变异性和局部不稳定性增加，特别是在以具有挑战性的速度行走时。这些结果对未来的患者教育和康复计划具有重要的参考价值。
Individuals with peripheral neuropathy (PN) may compensate for decreased somatosensation by reducing walking speed. Predisposition to falls may therefore arise from an inability to adapt to challenging walking speeds. The purpose of this study was to examine the effects of PN on the magnitude of variability and local instability on walking at different speeds. Twelve individuals with PN and 12 controls completed a 6-min walk test to determine fast walking speed (FWS). Sagittal plane hip knee and ankle joint angles were then calculated during 3 min of treadmill walking at 100% 80% and 60% FWS. The magnitudes of stride duration variability (SDvar) joint angle variability (JTvar) and both short and long-term Lyapunov exponents (used to estimate local instability) were calculated. The PN group walked slower than the control group (p < .001). With groups combined walking faster led to increased local instability and increased variability (p < .001). The PN group exhibited increased variability (SDvar p = .02 JTvar p = .01) over all speeds and exaggerated local instability (p < .05) when walking at the fasted speed. PN leads to increased walking variability and local instability particularly when walking at challenging speeds. These results are important to consider in future patient education and rehabilitation programs.