The effect of claudication pain on temporal and spatial gait measures during self-paced ambulation.
The effect of claudication pain on temporal and spatial gait measures during self-paced ambulation.
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DOI：
10.1177/1358863x09106836
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发表时间：
2010-02
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影响因子：
--
通讯作者：
Forrester L
中科院分区：
文献类型：
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作者：
Gardner AW;Montgomery PS;Ritti-Dias RM;Forrester L
我们确定了跛行疼痛对时间和空间步态特征的影响，以及单侧外周动脉疾病（PAD）患者在首选和快速自选步行速度下的行走对称性。研究了28例间歇性跛行限制的PAD患者。患者在无疼痛和经历跛行疼痛后，在24英尺便携式步态垫系统上以其首选的快速步伐行走。无痛和疼痛行走试验的顺序是随机的，并获得以下步态参数：速度，节奏，步长，摆动时间，站立时间，单支撑时间和双支撑时间。在自行选择的快速步速中，患者行走速度减慢3%（p = 0.020），同时由于步幅缩短3%（p < 0.001）而感到疼痛，并且他们的双站立时间更长（p = 0.024）。症状性腿部跛行疼痛导致单站次数增加（p = 0.007）。此外，步态变得不对称，疼痛，因为有症状的腿在摆动阶段的步态周期的百分比较高（p < 0.01），而在站立（p < 0.01）和单站（p < 0.01）的百分比较低。在无痛试验期间，所有测量值的Ambassador均对称。跛行疼痛会减慢首选和快速起搏时的行走速度，并在快速行走挑战行走功能时增加不对称性。随着跛行疼痛的发展而降低的步行速度可能是一种适应，以引起更安全和更不稳定的步态模式。
We determined the effect of claudication pain on temporal and spatial gait characteristics, and on ambulatory symmetry at preferred and rapid self-selected walking paces in patients with unilateral peripheral arterial disease (PAD). Twenty-eight patients with PAD limited by intermittent claudication were studied. Patients ambulated at their preferred and rapid paces over a 24-foot portable gait mat system while they were pain-free and after experiencing claudication pain. The order of the pain-free and painful walking trials was randomized, and the following gait parameters were obtained: velocity, cadence, stride length, swing time, stance time, single-support time, and double-support time. During the self-selected rapid pace, patients walked 3% slower (p = 0.020) while in pain due to a 3% shorter stride length (p < 0.001), and they were in double stance longer (p = 0.024). Claudication pain in the symptomatic leg resulted in an increase in single-stance (p = 0.007). Furthermore, gait became asymmetrical with pain, as the symptomatic leg spent a higher percentage of the gait cycle in the swing phase (p < 0.01), and lower percentages in stance (p < 0.01) and single-stance (p < 0.01) than the asymptomatic leg. Ambulation was symmetrical for all measures during the pain-free trial. Claudication pain slows ambulatory velocity at preferred and rapid paces, and increases asymmetry when ambulatory function is challenged with rapid walking. The reduced ambulatory speed with the development of claudication pain may be an adaptation to elicit a safer and less destabilizing gait pattern.