A comparison of gait biomechanics and metabolic requirements of overground and treadmill walking in people with stroke
A comparison of gait biomechanics and metabolic requirements of overground and treadmill walking in people with stroke
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DOI：
10.1016/j.clinbiomech.2009.07.004
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发表时间：
2009-11-01
影响因子：
1.8
通讯作者：
Olney, Sandra J.
中科院分区：
文献类型：
--
作者：
Brouwer, Brenda;Parvataneni, Krishnaji;Olney, Sandra J.
背景：对跑步机和地上行走的比较表明，在跑步机上行走的时间-距离测量的对称性更好，这表明步态经济性更好。我们通过检查运动学来检查这个问题。运动和代谢需求与地面和跑步机步行的匹配速度有关，并探讨了增加跑步机速度的影响。方法：10例偏瘫患者以自己喜欢的速度在跑步机上行走。然后皮带的速度比首选速度提高10%和20%。在稳定状态下（稳定心率和摄氧量）记录时间距离结果、角运动学和垂直地面反作用力。研究发现：在地面上行走时，步伐和站立时间更长，但两种地面的对称程度相当。相反，运动学数据显示，在地上行走过程中，所有下肢关节运动都存在显著的肢间不对称性，同时蹬离时垂直地面反作用力较高。然而，在地面上行走的代谢需求比在跑步机上行走的要低。增加皮带速度增加角位移和垂直力与四肢相关，使对称保持不变。代谢需求显著增加。解释：中风患者在跑步机上采用更对称的运动步行模式，保持更快的皮带速度。令人惊讶的是，在相同的速度下，与跑步机行走相比，代谢成本明显更高。我们建议进一步研究，以探讨是否增加依赖臀部肌肉来补偿较低的推离力可以解释较高的能量消耗。2009爱思唯尔有限公司版权所有。
Background: Comparisons of treadmill and overground walking following stroke indicate that symmetry in temporal-distance measures is better on the treadmill suggestive of better gait economy. We examined this issue by examining the kinematic. kinetic and metabolic demands associated with overground and treadmill walking at matched speeds and also explored the effect of increasing treadmill speed.Methods: Ten people with hemiparesis walked overground at their preferred speed which was matched on the treadmill. Belt speed was then increased 10% and 20% above preferred speed. Temporal-distance outcomes, angular kinematics and vertical ground reaction forces were recorded during steady state (stable heart rate and oxygen uptake).Findings: Step and stance times were longer when walking overground but the degree of symmetry was comparable for both surfaces. In contrast kinematic data revealed significant interlimb asymmetry with respect to all lower limb joint excursions during overground walking accompanied by higher vertical ground reaction forces at push-off. The metabolic demands, however, were lower when walking overground than on the treadmill. Increasing the belt speed increased angular displacements and the vertical forces associated with both limbs such that symmetry remained unchanged. Metabolic demands increased significantly.Interpretation: People with stroke adopt a more symmetrical kinematic walking pattern on the treadmill which is maintained at faster belt speeds. Surprisingly, at matched speed the metabolic cost was significantly higher with treadmill walking. We suggest further research to explore whether an increased reliance on the hip musculature to compensate lower push-off forces could explain the higher the energy cost. (C) 2009 Elsevier Ltd. All rights reserved.