Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis.
Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis.
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DOI：
10.1186/s12984-021-00891-7
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发表时间：
2021-06-27
影响因子：
5.1
通讯作者：
Fey NP
中科院分区：
文献类型：
--
作者：
Neuman RM;Shearin SM;McCain KJ;Fey NP
步态障碍是多发性硬化症（MS）的常见并发症。步态限制，如髋关节屈曲受限、足下垂和膝关节过伸，通常需要外部设备，如拐杖、手杖和矫形器。为MS患者规定的移动辅助技术（MAT）的效果尚未得到很好的理解，目前的设备不能满足这些人的特定需求。为了解决这个问题，被动单侧髋关节屈曲辅助矫形器（HFO）的开发，使用跨髋关节的阻力带重新定向步态周期中的能量。本研究的目的是研究HFO对MS患者和非MS患者的步态力学和肌肉激活的短期影响。我们假设（1）佩戴器械的肢体髋关节屈曲会增加，（2）髋关节伸肌的肌肉活动会增加，髋关节屈肌和跖屈肌的肌肉活动会减少。五名健康受试者和五名MS受试者使用三种不同水平的带刚度使用该设备行走了一分钟。我们分析了峰值髋关节屈曲和伸展角度，下肢关节工作，以及下肢和躯干上八块肌肉的肌肉活动。由于受试者间变异性，使用了单受试者分析。对于MS受试者，HFO导致峰值髋关节屈曲角增加和峰值髋关节伸展角减少，证实了我们的第一个假设。健康受试者在使用该器械时表现出不太明显的运动学变化。使用HFO时，大多数受试者髋关节产生的功率增加。第二个假设未得到证实，因为肌肉活动显示出不一致的结果，但是几名受试者表现出HFO增加的髋伸肌和躯干肌肉活动。这项探索性研究表明，健康受试者和MS受试者对HFO耐受良好，并且它促进了MS患者髋关节的更规范的运动学。需要更长时间暴露于HFO和个性化辅助参数的未来研究，以了解HFO对MS患者移动辅助和康复的功效。在线版本包含补充材料，可在10.1186/s12984-021-00891-7。
Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors. Five healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability. For subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO. This exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS. The online version contains supplementary material available at 10.1186/s12984-021-00891-7.
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DOI：
10.1016/s1474-4422(20)30308-2
发表时间：
2020-11
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Matschke J;Lütgehetmann M;Hagel C;Sperhake JP;Schröder AS;Edler C;Mushumba H;Fitzek A;Allweiss L;Dandri M;Dottermusch M;Heinemann A;Pfefferle S;Schwabenland M;Sumner Magruder D;Bonn S;Prinz M;Gerloff C;Püschel K;Krasemann S;Aepfelbacher M;Glatzel M
通讯作者：
Glatzel M
影响因子：
2.4
作者：
Campanini, I.;Merlo, A.;Damiano, B.
通讯作者：
Damiano, B.
影响因子：
5.2
作者：
Kang, Inseung;Hsu, Hsiang;Young, Aaron
通讯作者：
Young, Aaron
影响因子：
2.4
作者：
Goldberg, SR;Anderson, FC;Delp, SL
通讯作者：
Delp, SL
影响因子：
4.3
作者：
Grazi L;Crea S;Parri A;Molino Lova R;Micera S;Vitiello N
通讯作者：
Vitiello N