青年慢性非特异性腰痛患者步态:时空和动力学参数特征

Gait characteristics of youth with chronic non-specific low back pain:spatio-temporal and kinetic parameters

背景:非特异性腰痛严重影响人们的工作生活,步态训练可以有效处理慢性腰痛。研究慢性非特异性腰痛患者步态有助于设计出更有针对性的步态再教育内容。目的:通过比较健康青年人与青年慢性非特异性腰痛患者步态时空和力学参数,以期发现青年慢性非特异性腰患者步态特征,为慢性非特异性腰痛患者诊断、康复提供参考。方法:共65例志愿者参与试验,其中健康青年人30例,慢性非特异性腰痛患者35例,用LORAN足底压力2 m平板及配套步态测试系统测试其常速走的步态。结果与结论:(1)慢性非特异性腰痛组步长对称指数显著大于健康对照组(P <0.01);站立相对称指数、单支撑时间对称指数均显著大于健康对照组(P均<0.01);(2)健康对照组两侧步态时空参数差异均无显著性意义(P均>0.05);慢性非特异性腰痛组右侧步长、足偏角显著大于左侧(P <0.01,<0.05);右侧站立相、单支撑相显著长于左侧,左侧双支撑相长于右侧(P均<0.01);(3)慢性非特异性腰痛组初始双支撑相、单支撑、终末双支撑相垂直地面反作用力对称指数均显著大于健康对照组(分别为P <0.05,<0.01,<0.05);(4)结果提示,青年慢性非特异性腰痛患者常速走步态比健康青年人更不对称,青年慢性非特异性腰痛患者过多的应用优势侧肢体提供支撑;在对青年慢性非特异性腰痛患者进行步态再教育时,需考虑对患者不对称的肢体支撑模式进行调整。

BACKGROUND:Chronic non-specific low back pain seriously affects people’s working and life.Gait training does help to treat chronic low back pain.Studying the gait of chronic non-specific low back pain patients can help us design more targeted gait re-education content.OBJECTIVE:To find the gait characteristics of young chronic non-specific low back pain patients by comparing the spatio-temporal parameters and mechanical parameters of gait among between healthy youth and youth with chronic non-specific low back pain,so as to provide a reference for the diagnosis and rehabilitation of chronic non-specific low back pain.METHODS:Sixty-five volunteers were enrolled,including 30 healthy youth(control group),and 35 youth with chronic non-specific low back pain(trial group).The gait during normal movement was detected using LORAN 2-m footscan plantar pressure plate and gait testing system.RESULTS AND CONCLUSION:(1)The step length symmetry index,standing phase symmetry index and single-support phase symmetry index in the trial group were significantly higher than those in the control group(all P<0.01).(2)The spatio-temporal parameters of gait between two sides in the control group showed no significant differences(all P>0.05).In the trail group,the step length and foot angle deviation of the right side were significantly higher than those of the left side(P<0.01,P<0.05).The standing phase and single support time of the right side were significantly longer than those of the left side(all P<0.01).(3)The vertical ground reaction force symmetry index of initial double-support,single-support,and final double-support in the trial group were all significantly higher than that in the control group(P<0.05,P<0.01,P<0.05).(4)In summary,the youth with chronic non-specific low back pain are more likely to have asymmetrical gait than healthy youth.Youth with chronic non-specific low back pain are preferred to support by dominant limbs.In gait re-education for youth with chronic non-specific low back pain,asymmetrical limb support mode should be adjusted.