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首页> 外文期刊>Gait & posture >Kinetics of compensatory gait in persons with myelomeningocele.
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Kinetics of compensatory gait in persons with myelomeningocele.

机译：脊髓膜囊膨出患者代偿性步态的动力学。

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This study investigated the kinetic strategy and compensatory mechanisms during self-ambulatory gait in children with lumbo-sacral myelomeningocele. Thirty-one children with mid-lumbar to low-sacral myelomeningocele who walked without aids and 21 control children were evaluated by three-dimensional gait analysis. Joint moments in all planes at the hip and knee and sagittal moments at the ankle, as well as joint power and work done at all three joints, were analyzed. Joint moment capacity lost due to plantarflexor and dorsiflexor weakness was provided instead by orthotic support, but other joints were loaded more to compensate for the weakness at the ankles and restricted ankle motion. Subjects with total plantarflexor and dorsiflexor paresis and strength in the hip abductors had more knee extensor loading due to plantarflexor weakness and dorsiflexion angle of the orthotic ankle joint. The subjects with orthoses also generated more power at the hip to supplement the power generation lost to plantarflexor weakness and fixed ankles. The most determinant muscle whose paresis changes gait kinetics was the hip abductor. Hip abductor weakness resulted in a characteristic pattern where the hips displayed an eccentric adduction moment, mediating energy transfer into the lower limbs, and the hips replaced the knees as power absorbers in early stance. Joint moment, power and work analyses complement a kinematic analysis to provide a complete picture of how children who have muscle paresis recruit stronger muscle groups to compensate for weaker ones.
机译：本研究调查了腰s部脊髓膜脑袋膨出症患儿自我活动步态的动力学策略和补偿机制。通过三维步态分析评估了31名腰椎中段至低s肌脊髓膜膨出的儿童和21名对照儿童，这些儿童没有助行器行走。分析了髋部和膝部所有平面的关节力矩以及脚踝处的矢状力矩，以及所有三个关节的关节力量和所做的工作。由于足底屈肌和背屈肌无力而失去的关节力矩能力由矫形支撑提供，但其他关节的负荷更大，以弥补脚踝的无力和受限的踝关节运动。由于足屈肌无力和矫正踝关节的背屈角，足底屈肌和背屈肌轻瘫且髋外展肌力量较弱的受试者膝关节伸肌负荷更大。患有矫形器的受试者还在髋部产生了更多的力量，以补充因plant屈肌无力和脚踝固定而失去的力量。臀部改变步态动力学最决定性的肌肉是髋关节外展肌。髋关节外展肌无力导致了一种特征性的模式，即髋部表现出偏心的内收力矩，介导能量转移至下肢，并且在早期站立时，髋部代替了膝盖作为能量吸收器。关节力矩，力量和工作分析补充了运动学分析，可提供有关肌肉麻痹儿童如何募集更强壮的肌肉群以弥补较弱的肌肉群的完整图片。

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