杜氏肌营养不良症患儿上半身步态偏差。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106402

Jacqueline Romkes , Katrin Bracht-Schweizer , Michèle Widmer , Morgan Sangeux , Elke Viehweger

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引用次数: 0

摘要

背景：杜氏肌营养不良主要是一种累及全身的进行性肌肉变性疾病。尽可能长时间地保持患者的行走能力是很重要的。关于杜氏肌营养不良步态模式的不确定性信息适用于下半身，而缺失于上半身。本研究旨在客观地调查一组杜氏肌营养不良症患者与正常同龄人的上半身步态偏差。方法：回顾性分析12例男孩杜氏肌营养不良患者的三维全身步态数据。研究人员将数据与16名同龄、走路速度相似的健康儿童进行了比较。统计检验包括学生独立t检验（采用Holm-Bonferroni校正）、效应大小的Hedges’g检验和统计非参数映射双样本t检验（采用Bonferroni校正）。结果：与健康组相比，杜氏肌营养不良：在矢状面，胸段向后倾斜。此外，骨盆与胸椎段的相对角度随着肩部伸展的增加而向后倾斜。在额平面，患者行走时肩部外展增加，步幅增大。在横切面上，各组间胸腔旋转无明显差异。胸廓三个平面的活动范围均增加。解释：包括上半身步态运动学，特别是躯干的运动学，为理解杜氏肌营养不良症的步态模式增加了有价值的客观信息。我们的研究结果有助于提高对该患者组全身步态补偿的理解。

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Upper body gait deviations in children with Duchenne muscular dystrophy

Background

Duchenne muscular dystrophy is primarily a disease of progressive muscle degeneration affecting the whole body. It is important to preserve the patients' walking ability as long as possible. Inconclusive information on Duchenne muscular dystrophy gait pattern is available for the lower body and missing for the upper body. This study aimed to objectively investigate upper body gait deviations in a group of patients with Duchenne muscular dystrophy compared to typically developing peers.

Methods

Kinematic data of twelve boys with Duchenne muscular dystrophy that underwent three-dimensional full-body gait analysis were investigated retrospectively. Data were compared to sixteen healthy children of same age at similar walking speed. Statistical tests included the student independent t-test (with Holm-Bonferroni correction), Hedges'g for effect size, and statistical non-parametric mapping two-sample t-test (with Bonferroni correction).

Findings

Duchenne muscular dystrophy compared to the healthy group: In the sagittal plane, the thorax segment was more posteriorly tilted. In addition, the relative angle between pelvis and thorax segment showed more backwards lean with increased shoulder extension. In the frontal plane, the patients walked with increased shoulder abduction and took wider strides. In the transverse plane, thorax rotation was not different between groups. Thorax range of motion was increased in all three planes.

Interpretation

Including the upper body gait kinematics, especially of the trunk, adds valuable objective information on the understanding of the Duchenne muscular dystrophy gait pattern. Our findings contribute to improved understanding of full-body gait compensations in this patient group.

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来源期刊

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.