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Effects of visual restoration on gait performance and kinematics of lower extremities in patients with age-related cataract
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作者 mingxin ao Huijuan Shi +3 位作者 Xuemin Li Hongshi Huang Yingfang ao Wei Wang 《Chinese Medical Journal》 SCIE CAS CSCD 2023年第5期596-603,共8页
Background:Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly;however,the mechanism needs to be explored intensively.The present study assessed the gait pattern after catar... Background:Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly;however,the mechanism needs to be explored intensively.The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion.Methods:The prospective study recruited 32 patients(70.1±5.2 years)with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019.The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units.Paired t-test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed.Results:After visual restoration,the walking speed increased by 9.3%(1.19±0.40 m/s vs.1.09±0.34 m/s,P=0.008)and exhibited an efficient gait pattern with significant decrease in gait cycle(1.02±0.08 s vs.1.04±0.07 s,P=0.012),stance time(0.66±0.06 s vs.0.68±0.06 s,P=0.045),and single support time(0.36±0.03 s vs.0.37±0.02 s,P=0.011).High amplitude of joint motion was detected in the sagittal plane in the left hip(37.6°±5.3°vs.35.5°±6.2°,P=0.014),left thigh(38.0°±5.2°vs.36.4°±5.8°,P=0.026),left shank(71.9°±5.7°vs.70.1°±5.6°,P=0.031),and right knee(59.1°±4.8°vs.56.4°±4.8°,P=0.001).The motor symmetry of thigh improved from 8.35±5.30%to 6.30±4.73%(P=0.042).Conclusions:The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion.Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait. 展开更多
关键词 Biomechanical phenomena CATARACT GAIT REHABILITATION Visual perception
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不同设计多焦点人工晶状体植入后视觉质量差异的临床研究
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作者 王晓宇 李亚新 +6 位作者 刘一昀 耿嘉懿 秦锐 李炎城 敖明昕 刘德海 齐虹 《中华眼科医学杂志(电子版)》 2022年第4期210-215,共6页
目的比较三焦点衍射型人工晶状体(IOL)和双焦点折射型IOL植入后患者的术后视觉质量差异。方法回顾性队列研究。收集2019年3月至2020年7月于北京大学第三医院眼科行超声乳化白内障吸除联合后房型IOL植入的52例(104只眼)患者。其中,男性17... 目的比较三焦点衍射型人工晶状体(IOL)和双焦点折射型IOL植入后患者的术后视觉质量差异。方法回顾性队列研究。收集2019年3月至2020年7月于北京大学第三医院眼科行超声乳化白内障吸除联合后房型IOL植入的52例(104只眼)患者。其中,男性17例(34只眼),女性35例(70只眼);年龄36~87岁,平均年龄(69.3±11.2)岁。根据患者植入IOL种类分为区域折射组和衍射三焦组。区域折射组植入Lenstec SBL-3型IOL;衍射三焦组植入AT LISA tri 839MP型三焦点IOL。比较患者术后3个月裸眼近视力(UNVA)、裸眼中视力(UIVA)及裸眼远视力(UDVA),最佳矫正视力(BCVA)、离焦曲线、客观视觉质量、脱镜率、不良视觉现象及满意度。两组患者视功能相关生活质量问卷评分以(±s)表示;UNVA、UIVA、UDVA、BCVA、调制传递函数截止频率(MTF cut-off)、斯特列尔比(SR)、客观散射指数(OSI)、对比度视力(VA)及患者满意度以中位数和四分位数表示,组间比较采用Mann-Whitney U检验。等效球镜屈光度(SE)的分布、脱镜率及不良视觉率以百分比表示,组间比较采用χ^(2)检验。Spearman相关性分析患者术后客观视觉质量与BCVA的关系。结果衍射三焦组术后最小分辨角度对数视力(logMAR)UNVA、UIVA、UDVA及BCVA分别为0.10(0.05,0.10)、0.10(0.00,0.20)、0.10(0.10,0.20)及0.00(0.00,0.05);区域折射组分别为0.05(0.00,0.10)、0.10(0.00,0.20)、0.10(0.00,0.20)及0.00(0.00,0.05),UNVA比较的差异有统计学意义(Z=-2.596,P<0.05)。衍射三焦组SE在±0.25 D、±0.50 D、±0.75 D及±1.00 D处,分布分别占34.6%、65.4%、90.4%及100.0%;区域折射组SE在±0.25 D、±0.50 D、±0.75 D及±1.00 D处,分别占57.7%、71.2%、78.9%及92.4%。两组SE整体分布比较的差异有统计学意义(χ^(2)=27.083,P<0.05)。两组平均SE分别为(-0.38±0.43)D和(-0.25±0.49)D,差异无统计学意义(t=0.667,P>0.05)。离焦曲线分析显示,球镜屈光度为2.00 D、-2.00 D及-2.50 D时两组患者的logMAR BCVA比较的差异均有统计学意义(Z=-2.378,-2.416,-2.821;P<0.05)。衍射三焦组术后MTF cut-off、SR、OSI、VA 100%、VA 20%及VA 9%分别为27.7(21.2,37.6)c/deg、0.14(0.10,0.21)、2.4(1.7,2.9)、0.9(0.7,1.3)、0.6(0.4,0.8)及0.3(0.2,0.5);区域折射组分别为18.8(14.1,24.4)c/deg、0.11(0.09,0.13)、2.4(1.8,3.2)、0.6(0.5,0.8)、0.4(0.3,0.5)及0.2(0.2,0.3)。两组患者术后MTF cut-off、SR、OSI、VA 100%、VA 20%及VA 9%与logMAR BCVA呈正相关,且有统计学意义(r=-0.352,-0.211,0.542,0.324,-0.314,-0.287;P<0.05)。OSI与logMAR BCVA的相关度最高且两组间OSI比较的差异无统计学意义(Z=-0.807,P>0.05)。两组患者视功能相关生活质量问卷总分分别为(88.28±11.41)分和(87.43±12.62)分;视近脱镜率分别为80.8%和84.6%;不良视觉现象出现概率分别为23.1%和19.2%;平均满意度分别为3(3,4)和3(3,4)。结论两种多焦点IOL均能提高患者术后的主客观视觉质量,术后的有效性、准确性、生活质量、术后脱镜率及满意度相当;此外,区域折射组的术后UNVA优于衍射三焦组,衍射三焦组客观视觉质量均优于区域折射组,OSI可作为早期后囊膜混浊发现及手术时机选择的指标。 展开更多
关键词 白内障 人工晶状体 视觉质量 脱镜率
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