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The evolution of clinical gait analysis part III--kinetics and energy assessment.

机译：临床步态分析的演变第三部分-动力学和能量评估。

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Historically, clinical applications of measurements of force and energy followed electromyography and kinematics in temporal sequence. This sequence is mirrored by the order of topics included in this trilogy on the Evolution of Clinical Gait Analysis, with part I [Sutherland DH. The evolution of clinical gait analysis part I: kinesiological EMG. Gait Posture 2001;14:61-70.] devoted to Kinesiological EMG and part II [Sutherland DH. The evolution of clinical gait analysis part II - kinematics. Gait Posture 2002;16(2):159-179.] to Kinematics. This final review in the series will focus on kinetics as it relates to gait applications. Kinematic measurements give the movements of the body segments, which can be compared with normal controls to identify pathological gait patterns, but they do not deal with the forces controlling the movements. As a major goal of scientifically minded clinicians is to understand the biomechanical forces producing movements, the objective measurement of ground reaction forces is essential. The force plate (platform) is now an indispensable tool in a state-of-the-art motion analysis laboratory. Nonetheless, it is not a stand-alone instrument as both kinematic and EMG measurements are needed for maximum clinical implementation and interpretation of force plate measurements. The subject of energy assessment is also given mention, as there is a compelling interest in whether walking has been made easier with intervention. The goals of this manuscript are to provide a historical background, recognize some of the important contributors, and describe the current multiple uses of the force plate in gait analysis. The widespread use of force plates for postural analyses is an important and more recent application of this technology, but this review will be restricted to measurements of gait rather than balance activities. Finally, this manuscript presents my personal perspective and discusses the developments and contributors that have shaped my thoughts and actions, and which I have foundto be particularly noteworthy or intriguing. Just as in parts I and II, emphasis has been placed on the early development. All subtopics and important contributors, in this third and certainly most challenging of the review papers, have not been included. Some may find that my perceptions are incomplete. I accept responsibility for all deficiencies, as none were intended. Letters to selected contributors and their responses reveal how each contributor built on the work of others. The level of cooperation and sharing by these early investigators is extraordinary. Had they wished to withhold information about their own work, clinical gait analysis would have been severely delayed.
机译：从历史上看，力和能量测量的临床应用遵循肌电图和运动学按时间顺序进行。此顺序反映了该三部曲中有关步态分析演变的主题顺序，其中包括第一部分[Sutherland DH。临床步态分析的演变第一部分：运动学肌电图。 [Gait Posture 2001; 14：61-70。]专用于运动机能肌电图和第二部分[Sutherland DH。临床步态分析的演变第二部分-运动学。步态姿势2002; 16（2）：159-179。]。本系列的最后一篇文章将重点讨论与步态应用相关的动力学。运动学测量可以给出身体各部分的运动，可以将其与正常控件进行比较以识别病理性步态，但是它们不能处理控制运动的力。具有科学头脑的临床医生的主要目标是了解产生运动的生物力学力，因此，对地面反作用力的客观测量至关重要。测力板（平台）现在是最先进的运动分析实验室中不可或缺的工具。但是，它不是独立的仪器，因为运动学和EMG测量都需要最大的临床实施和测力板测量的解释。还提到了能量评估的主题，因为人们对是否通过干预使步行变得更容易引起了极大的兴趣。该手稿的目的是提供历史背景，认识一些重要的贡献者，并描述步态分析中测力板的当前多种用途。测力板在姿势分析中的广泛使用是该技术的重要和较新的应用，但是本次审查将仅限于步态的测量而不是平衡活动。最后，这份手稿提出了我的个人观点，并讨论了影响我的思想和行动的发展和贡献者，我发现这些发展和贡献者特别值得注意或耐人寻味。就像在第一部分和第二部分中一样，重点放在早期开发上。在本评论文件的第三篇中，当然也是最具挑战性的，都没有包括所有子主题和重要贡献者。有些人可能会发现我的看法不完整。对于所有缺陷，我均承担责任，因为没有任何缺陷。给选定贡献者的信及其回应揭示了每个贡献者如何建立在他人的工作之上。这些早期研究者的合作和分享水平非常高。如果他们希望保留有关自己工作的信息，那么临床步态分析将被严重延迟。

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