Biofeedback training for the analysis of gait stereotypes in patients with gonarthrosis

N. Nikolaev, R. Petrova, Elena V. Viktorova, E. V. Preobrazhenskaya
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Abstract

BACKGROUND: The justification of the treatment techniques for patients with gonarthrosis requires the use of modern methods for assessing walking stereotypes. AIM: This study aimed to evaluate the biomechanical and podometric gait parameters of patients with gonarthrosis using the C-Mill multifunctional complex with biofeedback. MATERIALS AND METHODS: The study included 55 patients who were divided into the following groups: main group (n=35) of patients who had gait disturbances, diagnosed with stage III–IV primary gonarthrosis with varus deformation of the limb axis according to ICD-10, and underwent total knee replacement and control group (n=20) of patients diagnosed with stage I primary gonarthrosis. The average age of patients was 58.7 years in the main group and 47.5 years in the control group. RESULTS: In the main group, the decrease in average walking speed was accompanied by decreases in stride length and step frequency (р 0.05). In the stance phase, which is characterized by the contact of the foot of the affected and contralateral lower extremities with the platform surface, the durations of the double stance phase of both extremities in the main group were longer than those in the control group (p 0.05), indicating gait asymmetry and redistribution of excess load on the contralateral lower extremity, which is clinically manifested by lameness. In the main group, gait was characterized by a decrease in voluntary speed, step frequency, and gait pattern changes in various planes, confirming severe clinical and functional disorders in the lower limbs. CONCLUSION: The study of the walking stereotype in patients using the C-Mill multifunctional complex with biofeedback can be used to substantiate treatment techniques, followed by drawing up an individual medical rehabilitation plan to restore lower limb functions in the postoperative period, fully monitor treatment dynamics, prevent falls, and improve the quality of life of patients.
生物反馈训练用于分析踝关节病患者的步态定型
背景:要证明对强直性脊柱炎患者的治疗技术是正确的,就必须使用现代方法来评估行走定型。目的:本研究旨在使用带有生物反馈功能的 C-Mill 多功能复合器评估踝关节病患者的生物力学和足部测量步态参数。材料与方法:研究纳入了 55 名患者,将其分为以下两组:主组(35 人)为有步态障碍的患者,根据 ICD-10 诊断为原发性踝关节病 III-IV 期且肢体轴线曲折变形,并接受了全膝关节置换术;对照组(20 人)为诊断为原发性踝关节病 I 期的患者。主组患者的平均年龄为 58.7 岁,对照组患者的平均年龄为 47.5 岁。结果:在主要组中,平均步行速度的下降伴随着步长和步频的下降(р 0.05)。在以患侧和对侧下肢足部与平台表面接触为特征的站立阶段,主要组双侧下肢双站立阶段的持续时间均长于对照组(P 0.05),这表明步态不对称,多余负荷重新分配到对侧下肢,临床表现为跛行。在主要组中,步态的特点是自主速度下降、步频降低和步态模式在不同平面上的变化,证实了下肢严重的临床和功能障碍。结论:研究使用 C-Mill 多功能复合器械的患者的行走定型与生物反馈,可用于证实治疗技术,随后制定个体医疗康复计划,以恢复术后患者的下肢功能,全面监测治疗动态,防止跌倒,提高患者的生活质量。
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