直立行走最佳化步态研究

Optimization of Upright Walking Gait:A Comprehensive Study

目的:本研究评定缩髋和挺髋直立行走对步态、表面肌电产生的影响。方法:采用随机交互设计,15名健康男性受试者(平均年龄:20.80±2.04岁;身高:173.99±2.87 cm;体重:68.53±3.21 kg)分别完成2次直立行走(缩髋和挺髋),分别采用Vicon运动捕捉系统和AMTI测力台检测步态参数的变化,并检测表面肌电。结果:与缩髋步态相比,时空数据显示挺髋行走时左侧步频、步速、步长显著增加(P<0.05),步幅时间、单支撑时间显著减少(P<0.05),右侧步幅时间、步长时间、双支撑时间显著减小(P<0.05),其余指标无显著差异(P>0.05);运动学指标显示左侧踝关节内收角度(P<0.05)、髋关节伸角(P<0.01)、膝关节伸角(P<0.05)显著增加;右侧踝关节跖屈角度,髋关节伸角、内收角度,膝关节伸角、内收角度显著增加(P<0.05),其余指标无显著差异(P>0.05);动力学指标左侧髋关节前向剪切力(P<0.01)、髋关节张力、膝关节张力显著增加(P<0.05);右侧踝关节后向剪切力(P<0.01)、髋关节前向剪切力(P<0.01)、右膝关节张力(P<0.05)显著增加。左侧髋关节弯曲力矩(P<0.01)、伸展力矩(P<0.05),膝关节伸展力矩(P<0.01)显著增加;右侧踝关节跖屈力矩(P<0.05)、外展力矩(P<0.05),髋关节弯曲力矩(P<0.05)、伸展力矩(P<0.001)、内收力矩(P<0.01),膝关节伸展力矩(P<0.05)、外展力矩(P<0.05)显著增加。另外,表面肌电显示,股直肌(P<0.01)、股内侧肌(P<0.05)、股外侧肌(P<0.05)sEMG平均值显著增加;股直肌(P<0.01)、股内侧肌(P<0.05)、股外侧肌(P<0.05)iEMG值显著增加;股直肌(P<0.01)、股外侧肌(P<0.05)、胫骨前肌(P<0.05))sEMG峰值显著增加,其余指标无显著差异(P>0.05)。结论:整体上,研究表明挺髋行走,髋、膝、踝动力链发生局部调整,下肢激活程度增加,支持力向上传递,依据作用力与反作用力的原理,从而整体上缓解下肢的压力,因此,挺髋直立行走应为最佳化的步态。

OBJECTIVE:This study aimed to assess the impact of hip flexion and hip extension on gait and surface electromyography(sEMG)in upright walking.METHODS:Using a randomized crossover design,15 healthy male participants(mean age:20.80±2.04 years;height:173.99±2.87 cm;weight:68.53±3.21 kg)completed two types of upright walking(with hip flexion and hip extension).Changes in gait parameters were recorded using the Vicon motion capture system and AMTI force platform,and sEMG data was collected.RESULTS:In comparison to hip flexion gait,spatiotemporal data indicated that during hip extension walking,there was a significant increase in left step frequency,step speed,and step length(P<0.05),along with a decrease in step duration and single support time(P<0.05).Right step duration,step length,and double support time also decreased significantly(P<0.05),while other parameters showed no significant differences(P>0.05).Kinematic measurements showed significant increases in left ankle joint inversion angle(P<0.05),hip joint extension angle(P<0.01),and knee joint extension angle(P<0.05).Right ankle joint dorsiflexion angle,hip joint extension angle,inversion angle,knee joint extension angle,and inversion angle increased significantly(P<0.05),with no significant differences in other measures(P>0.05).Kinetic measures demonstrated significant increases in left hip joint anterior shear force(P<0.01),hip joint tension,and knee joint tension(P<0.05).Right ankle joint posterior shear force(P<0.01),left hip joint anterior shear force(P<0.01),and right knee joint tension(P<0.05)increased significantly.Left hip joint flexion moment(P<0.01),extension moment(P<0.05),and knee joint extension moment(P<0.01)increased significantly.Right ankle joint dorsiflexion moment(P<0.05),eversion moment(P<0.05),hip joint flexion moment(P<0.05),extension moment(P<0.001),inversion moment(P<0.01),knee joint extension moment(P<0.05),and eversion moment(P<0.05)increased significantly.Additionally,surface electromyography data revealed a significant increase in the average values of rectus femoris(P<0.01),vastus medialis(P<0.05),and vastus lateralis(P<0.05)sEMG.The iEMG values of rectus femoris(P<0.01),vastus medialis(P<0.05),and vastus lateralis(P<0.05)also increased significantly.The peak values of rectus femoris(P<0.01),vastus lateralis(P<0.05),and tibialis anterior(P<0.05)sEMG significantly increased,while other measures showed no significant differences(P>0.05).CONCLUSION:In summary,this study indicates that hip extension walking leads to localized adjustments in the hip,knee,and ankle kinetic chain,an increased activation of the lower extremities,and a more efficient transmission of support forces.Based on the principles of action and reaction forces,hip extension upright walking should be considered an optimized gait.