Clinical gait analysis reveals altered walking patterns in critical Covid 19 survivors

IF 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL
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Abstract

Background

Covid-19 has dramatically increased the number of admissions in intensive care units due to respiratory complications. In some cases, the arousal of neurological impairments, such as peripheral neuropathies, have been revealed. The purpose of this research was to characterize the gait pattern and muscle activity changes in Covid-19 survivors compared to physiological gait.

Methods

Twelve post-Covid-19 participants admitted to intensive care units and twelve non-disabled controls were considered. Kinematics, kinetics and surface electromyographic data were collected for each participant during walking. Post Covid-19 participants were further divided into two sub-groups, according to the number of days spent in the intensive care units. Lower limb joint angles, moments and powers were extracted as well as the muscle activity of four muscles bilaterally, the spatial, temporal and spatiotemporal parameters of gait and the ground reaction forces. The extracted variables were compared through OneWay-ANOVA or Kruskal-Wallis tests where appropriate (p < 0.05).

Findings

Overall, the considered parameters revealed statistically significant reduction in gait speed, cadence, range of motion in the sagittal plane, anteroposterior and vertical ground reaction forces between pathological and control participants. Larger alterations of the gait patterns were highlighted in the post-Covid-19 group hospitalized in intensive care units longer than 35 days, where a reduced muscle activity was observed on all the analyzed muscles.

Interpretation

Results suggested that the severity of gait impairments in post-Covid-19 participants might be correlated with intensive care units-bedding period. Gait biomechanics assessment could be adopted in the clinical decision-making process to improve treatment protocols in post-Covid-19 survivors.

临床步态分析显示,危重的 Covid 19 幸存者的行走模式发生了改变。
背景:Covid-19 使重症监护病房因呼吸系统并发症而入院的人数急剧增加。在一些病例中,神经系统损伤(如周围神经病)被暴露出来。本研究的目的是将 Covid-19 存活者的步态模式和肌肉活动变化与生理步态进行比较:方法:研究对象为 12 名入住重症监护室的 Covid-19 后幸存者和 12 名非残疾对照者。收集了每位参与者行走时的运动学、动力学和表面肌电图数据。根据在重症监护室度过的天数,Covid-19 后参与者被进一步分为两个亚组。提取了下肢关节角度、力矩和功率,以及双侧四块肌肉的肌肉活动、步态的空间、时间和时空参数以及地面反作用力。在适当的情况下,通过单向方差分析或 Kruskal-Wallis 检验对提取的变量进行比较(P 结果):总体而言,所考虑的参数显示,病理参与者和对照组参与者的步速、步幅、矢状面运动范围、前后和垂直地面反作用力均有统计学意义上的显著降低。在重症监护室住院超过35天的Covid-19后组中,步态发生了更大的变化,所有分析肌肉的活动均有所减少:结果表明,Covid-19 后参与者步态障碍的严重程度可能与重症监护室的住院时间有关。步态生物力学评估可用于临床决策过程,以改进对Covid-19后幸存者的治疗方案。
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来源期刊
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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