不同速度下正常老年人下肢关节的角度参数

Lower limbs angle parameter of elderly in different speeds

背景：目前国内主要采用步态分析仪测量患者步行时的关节角度,但是在每一个康复治疗时期进行这些测量非常耗费时间。利用Lokomat步态康复机器人则可以在患者训练过程中对患者的关节角度、肌力等参数进行实时记录,省时省力。目的：采用步态康复机器人Lokomat测定正常老年人不同速度下的下肢关节角度参数。方法：选取健康老年人30名,男15名,女15名,年龄60~64（62.40±1.58）岁。利用步态康复机器人评估工具,在减重40%,引导力60%,速度1.6,1.8,2.0km/h状态下对正常老年人的下肢关节角度参数进行记录。结果与结论：老年人关节角度参数动态指标测试结果显示,在速度1.6km/h状态下左髋关节最大伸展角度,在速度2.0km/h状态下左、右髋关节最大屈曲角度,男女组间差异有显著性意义（P〈0.05）。老年人不同速度下髋膝关节角度测试结果显示,老年人左右膝关节最大伸展角度在步行速度1.6km/h与1.8km/h,1.6km/h与2.0km/h,1.8km/h与2.0km/h相比差异有显著性意义（P〈0.05）。结果可见不同速度下髋关节最大屈曲角度男性大于女性,治疗师在进行Lokomat步态康复训练时应根据患者的性别差异,调整髋膝关节角度和训练模式。随着步行速度的增加老年人髋膝关节屈曲角度增加,伸展角度减小,治疗师应根据步速的增减适当调节髋膝关节活动度,增强患者腿部运动与机器人外骨骼式机械腿的配合,提高患者的训练效果。

BACKGROUND： At present, gait analysis is the main method to measure the joint angles of the patients when walking. However, these measurements in each rehabilitation period are time-consuming. Gait rehabilitation robot Lokomat can real-time record the joint angles and muscle parameters during exercise which is convenient. OBJECTIVE： To measure the lower limbs angle parameter of elderly in different speeds by gait rehabilitation robot Lokomat. METHODS： Thirty healthy elderly were selected as the research subjects, including 15 men and 15 women. The age was ranged from 60 to 64 years （62.40±1.58）. The lower limbs angle parameters of the elderly were recorded under the conditions of 40% weight losing and 60% guidance force and in the speed of 1.6 km/h, 1.8 km/h and 2.0 km/h, respectively. RESULTS AND CONCLUSION： Results of dynamic parameters of the subjects showed that there was significant difference of the maximum left hip extension angle under the speed of 1.6 km/h, and there was significant difference of the bilateral hip flexion angle under the speed of 2.0 km/h between male and female groups （P 0.05）. Measurement results of knee and hip joint of elderly under different speeds showed that there was significant difference of the maximum bilateral knee joint extension angle under the speed of 1.6 km/h and 1.8 km/h, 1.6 km/h and 2.0 km/h, 1.8 km/h and 2.0 km/h （P 0.05）. The maximum hip flexion angle in men was greater than that in women under different speeds. Therapists should adjust the joint angle and the training mode of hip and knee joint based on the gender when giving the Lokomat gait rehabilitation training. With the increasing of the hip and knee flexion angle, the extension angle is decreased, and the therapists should adjust the range of motion according to different walking speeds, in order to enhance the co-ordination of leg movements in patients with robot exoskeleton mechanical leg and improve the training effect.