Lower-limb biomechanics in motor neuron disease: a joint-level perspective of gait disruption.

IF 2.8
Cory J Holdom, James L Williamson, Georgia O'Reilly, Robert D Henderson, Sally Neville, Shyuan T Ngo, Taylor J M Dick, Frederik J Steyn
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Abstract

Background: Motor neuron disease (MND) profoundly impacts mobility, yet gait-specific dysfunctions due to MND remain poorly understood. Methods: We characterized lower-limb gait alterations in people living with MND (plwMND) using advanced biomechanical tools. Nine plwMND and nine non-neurodegenerative disease controls walked on an instrumented treadmill at self-selected speeds. Ground reaction forces and joint motions were measured to model lower-limb kinetics, kinematics, and energetics. Results: PlwMND had reduced forward propulsive (p < 0.001) and braking (p = 0.002) ground reaction forces. Ankle range of motion was 10.0 ± 3.1° lower (p = 0.035) with peak positive ankle moment and power 33% and 72% lower, respectively (both: p < 0.001), in plwMND compared to controls. Conclusions: These lower-limb impairments highlight the ankle as an early and critical locus of dysfunction, with distal weakness driving compensatory proximal strategies, increasing walking inefficiency and fatigue. Integrating biomechanical and clinical data offers new insights into gait disruption in MND, supporting the development of targeted, personalized interventions to maintain independent mobility.

运动神经元疾病中的下肢生物力学:步态紊乱的关节水平视角。
背景:运动神经元疾病(MND)深刻影响运动能力,然而由于MND引起的步态特异性功能障碍仍然知之甚少。方法:我们使用先进的生物力学工具对MND (plwMND)患者的下肢步态改变进行了表征。9名plwMND和9名非神经退行性疾病对照者在仪器跑步机上以自己选择的速度行走。测量地面反作用力和关节运动来模拟下肢动力学、运动学和能量学。结果:PlwMND降低了前推进地面反作用力(p p = 0.002)。踝关节活动范围降低10.0±3.1°(p = 0.035),踝关节峰值正力矩和力量分别降低33%和72% (p均为:p)。结论:这些下肢损伤突出了踝关节是早期和关键的功能障碍位点,远端无力驱动代偿性近端策略,增加了行走效率低下和疲劳。整合生物力学和临床数据为MND的步态中断提供了新的见解,支持有针对性的个性化干预措施的发展,以保持独立的行动能力。
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