Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized fo...Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.展开更多
Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training....Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.展开更多
BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with ...BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.展开更多
Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of jo...Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.展开更多
<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="fon...<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Gait asymmetry can become very pronounced in patie</span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">nts who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. </span><b><span style="font-family:Verdana;">OBJECTIVE</span></b><span style="font-family:Verdana;">: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. </span><b><span style="font-family:Verdana;">METHODS</span></b><span style="font-family:Verdana;">: This study employed a cross-sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were eva</span><span style="font-family:Verdana;">luated by spirometry. We examined the relation between SI or LI and the res</span><span style="font-family:Verdana;">piratory function/respiratory muscle strength in patients with stroke. </span><b><span style="font-family:Verdana;">RE</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">- </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">SULTS</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the </span><span><span style="font-family:Verdana;">LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = <span style="white-space:nowrap;">﹣</span>0.386, r = <span style="white-space:nowrap;">﹣</span>0.392, r = <span style="white-space:nowrap;">﹣</span>0.446;p < 0.05). </span><b><span style="font-family:Verdana;">CONCLUSION</span></b><span style="font-family:Verdana;">: </span></span><span style="font-family:Verdana;">The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.</span></span></span></span>展开更多
Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- i...The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.展开更多
Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older ...Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.展开更多
In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose th...In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose the ac- celerometer signals, thus sifting out several intrinsic mode functions （IMFs） at disparate scales. Then, gait series can be extracted through peak detection from the eigen IMF that best represents gait rhythmicity. Compared with the method based on the empirical mode decomposition （EMD）, the EEMD-based method has the following advantages： it remarkably improves the detection rate of peak values hidden in the original accelerometer signal, even when the signal is severely contaminated by the intermittent noises; this method effectively prevents the phenomenon of mode mixing found in the process of EMD. And a reasonable selection of parameters for the stop-filtering criteria can improve the calculation speed of the EEMD-based method. Meanwhile, the endpoint effect can be suppressed by using the auto regressive and moving average model to extend a short-time series in dual directions. The results suggest that EEMD is a powerful tool for extraction of gait rhythmicity and it also provides valuable clues for extracting eigen rhythm of other physiological signals.展开更多
Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes...Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.展开更多
AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibi...AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibial amputees were recruited.Twenty-eight able-bodied controls were recruited.All participants underwent 3DGA,the timed-up-and-go test and the six-minute walk test(6MWT).The lowerlimb amputees also completed the Prosthesis Evaluation Questionnaire.Results from 3DGA were summarised using the gait deviation index(GDI),which was subsequently regressed,using stepwise regression,against the other measures.RESULTS:Step-length(SL),self-selected walking speed(SSWS) and the distance walked during the 6MWT(6MWD) were significantly correlated with GDI.The 6MWD was the strongest,single predictor of the GDI,followed by SL and SSWS.The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility.CONCLUSION:This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA.展开更多
文摘Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.
基金supported by the Natural Science Foundation of China,No.30973165
文摘Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.
文摘BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.
文摘Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.
文摘<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Gait asymmetry can become very pronounced in patie</span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">nts who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. </span><b><span style="font-family:Verdana;">OBJECTIVE</span></b><span style="font-family:Verdana;">: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. </span><b><span style="font-family:Verdana;">METHODS</span></b><span style="font-family:Verdana;">: This study employed a cross-sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were eva</span><span style="font-family:Verdana;">luated by spirometry. We examined the relation between SI or LI and the res</span><span style="font-family:Verdana;">piratory function/respiratory muscle strength in patients with stroke. </span><b><span style="font-family:Verdana;">RE</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">- </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">SULTS</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the </span><span><span style="font-family:Verdana;">LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = <span style="white-space:nowrap;">﹣</span>0.386, r = <span style="white-space:nowrap;">﹣</span>0.392, r = <span style="white-space:nowrap;">﹣</span>0.446;p < 0.05). </span><b><span style="font-family:Verdana;">CONCLUSION</span></b><span style="font-family:Verdana;">: </span></span><span style="font-family:Verdana;">The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.</span></span></span></span>
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,Science and Technology(2012-013997)
文摘The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.
基金funded by the Shanghai City Committee of Science and Technology Key Project (No. 12490503200)the National Science Foundation for Distinguished Young Scholars of China (No. 81025022)
文摘Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 60501003 and 60701002)
文摘In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose the ac- celerometer signals, thus sifting out several intrinsic mode functions （IMFs） at disparate scales. Then, gait series can be extracted through peak detection from the eigen IMF that best represents gait rhythmicity. Compared with the method based on the empirical mode decomposition （EMD）, the EEMD-based method has the following advantages： it remarkably improves the detection rate of peak values hidden in the original accelerometer signal, even when the signal is severely contaminated by the intermittent noises; this method effectively prevents the phenomenon of mode mixing found in the process of EMD. And a reasonable selection of parameters for the stop-filtering criteria can improve the calculation speed of the EEMD-based method. Meanwhile, the endpoint effect can be suppressed by using the auto regressive and moving average model to extend a short-time series in dual directions. The results suggest that EEMD is a powerful tool for extraction of gait rhythmicity and it also provides valuable clues for extracting eigen rhythm of other physiological signals.
文摘Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.
文摘AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibial amputees were recruited.Twenty-eight able-bodied controls were recruited.All participants underwent 3DGA,the timed-up-and-go test and the six-minute walk test(6MWT).The lowerlimb amputees also completed the Prosthesis Evaluation Questionnaire.Results from 3DGA were summarised using the gait deviation index(GDI),which was subsequently regressed,using stepwise regression,against the other measures.RESULTS:Step-length(SL),self-selected walking speed(SSWS) and the distance walked during the 6MWT(6MWD) were significantly correlated with GDI.The 6MWD was the strongest,single predictor of the GDI,followed by SL and SSWS.The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility.CONCLUSION:This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA.
