ILIOPSOAS MUSCLE ACTIVITIES IN HEMIPLEGIC GAIT

偏瘫步态中的髂腰肌活动

• 批准号: 10838046
• 负责人: FUJIWARA Makoto
• 金额: $ 2.11万
• 依托单位: HYOGO COLLEGE OF MEDICINE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10838046/
• 关键词: Hemiplegia; Gait; Iliopsoas muscle

From the observation of time factor in hemiplegic gait, it was thought that the improvement of the gait speed might be dependent on the shortening of the stance phase of gait cycle, especially on the double accelerating stance period. Two structures were thought to have important roles for this period ; they were the role of anti-gravity muscles of the lower limb that represents the knee extension mechanism, and the role of the iliopsoas muscle that initiates swing of the lower limb. From EMG study of hemiplegic gait, followings were revealed1) Iliopsoas muscle showed phasic activity like the control group through the walking cycle, so that this muscle may not concern with prolongation of double accelerating period seen in hemiplegic gait.2) Gluteus medius, vastus lateralis, medial hamstrings showed dynamic muscle activities contributing to coordinative lower limb motion in normal walking cycle. In hemiplegic gait, their abnormal inappropriate activities in this period were thought as a factor that prolongs double accelerating period.3) Triceps surae was also thought as a factor of prolonged double accelerating period, disturbing optimal knee and hip flexion due to lack of dynamic discharge.4) Improving the double accelerating period or the walking capability in hemiplegic patients, supporting system of the lower limb must be focused rather than inappropriate iliopsoas activity which was hypothesized at the beginning of this research.

从偏瘫步态时间因素的观察来看，步态速度的提高可能依赖于步态周期站立期的缩短，尤其是双加速站立期的缩短。有两种结构被认为在这一时期发挥了重要作用：它们是代表膝关节伸展机制的下肢反重力肌的作用，以及启动下肢摆动的髂腰肌的作用。偏瘫步态的肌电图研究显示：1）髂腰肌在步行周期中表现出与对照组相似的阶段性活动，因此该肌肉可能与偏瘫步态中双加速期的延长无关。2）臀中肌、股外侧肌、内侧腘绳肌表现出动态肌肉活动，有助于正常步行周期中下肢的协调运动。在偏瘫步态中，该时期的异常不当活动被认为是双加速期延长的一个因素。3）小腿三头肌也被认为是双加速期延长的一个因素，由于缺乏动态放电，扰乱了膝关节和髋关节的最佳屈曲。4）改善偏瘫患者的双加速期或步行能力，必须关注下肢的支撑系统，而不是下肢的支撑系统。 在本研究开始时假设的髂腰肌活动不当。