Torque action of two-joint muscles in the swing period of stiff-legged gait: a forward dynamic model analysis
Torque action of two-joint muscles in the swing period of stiff-legged gait: a forward dynamic model analysis
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DOI：
10.1016/s0021-9290(98)00107-9
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发表时间：
1998-09-01
影响因子：
2.4
通讯作者：
Kerrigan, DC
中科院分区：
文献类型：
--
作者：
Riley, PO;Kerrigan, DC
以摆动期间膝关节屈曲有限为特征的硬腿步态是上运动神经元损伤的常见后果。本研究的目的是确定股直肌和腘绳肌（作用于髋关节和膝关节）是否在步态周期的摆动期间活跃，从而导致腿硬步态。对10例中风所致单侧腿僵直步态患者进行评估。获得无摆动周期步态数据。为每个受试者建立了受影响肢体的生物力学模型。肌肉和肌腱长度按个体受试者进行缩放，而所有受试者使用恒定的最大肌肉力标称值。采用力矩驱动前向动力学仿真方法，确定摆动周期最大膝关节屈曲角对髋关节和膝关节力矩变化的敏感性。结合扭矩和肌肉驱动的模拟来获取特定的双关节肌肉的动作。髋关节屈曲力矩和膝关节伸曲力矩均影响膝关节角度，但膝关节角度对膝关节力矩的变化更为敏感。股直肌和长腘绳肌的作用在膝盖处最为明显，尽管它们在臀部的作用与膝盖处的作用相反。股直肌活动在早期摆动的行为，以限制膝关节屈曲和有助于硬腿步态。早期挥拍时的长腿筋活动有助于膝关节屈曲。1998爱思唯尔科学有限公司版权所有。
Stiff-legged gait, characterized by limited knee flexion during the swing period, is a common consequence of upper motor neuron injury. The purpose of this investigation was to determine whether the rectus femoris and hamstrings muscles (which act at both the hip and knee) contribute to stiff-legged gait if active during the swing period of the gait cycle. Ten subjects with unilateral stiff-legged gait due to stroke were evaluated. Swing period free gait data were obtained. A biomechanical model of the affected limb was developed for each subject. Muscle and tendon lengths were scaled to individual subjects while constant nominal values for maximum muscle forces were used for all subjects. Torque driven forward dynamic simulations were employed to determine the sensitivity of swing period maximum knee flexion angle to changes in hip and knee torques. Combined torque and muscle driven simulations were used to access the action of specific two-joint muscles. Both hip flexion torque and knee extension torque were found to influence knee angle, but knee angle was more sensitive to changes in torque at the knee joint. The actions of the rectus femoris and long hamstrings are most marked at the knee, although their action at the hip opposes their action at the knee. Rectus femoris activity during early swing acts to limit knee flexion and contributes to stiff-legged gait. Long hamstring activity in early swing contributes to knee flexion. (C) 1998 Elsevier Science Ltd. All rights reserved.