多发性硬化症和低残疾的患者在步态开始时表现出谨慎的旋转行为。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2025.106431

C. Massot , J. Bègue , E. Simoneau-Buessinger , C. Donze , T. Caderby , S. Leteneur

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引用次数: 0

摘要

背景：多发性硬化症诱发运动障碍。目的是表征多发性硬化症对步态开始时全身角动量控制的影响。方法：15例扩展残疾状态量表为2.5的多发性硬化症患者和16名健康受试者进行步态启动。利用三维运动捕捉系统和两个测力板计算了时空参数、全身角动量、关于身体质心的净外力矩及其分量。结果：多发性硬化症患者在步态起始双支撑阶段横切面的全身角动量范围明显变小（p = 0.011），在初始双支撑阶段和执行阶段矢状面过渡阶段的净外力矩明显变小（p = 0.013）。在横切面上，多发性硬化症患者在双支撑阶段（p = 0.024）以及双支撑阶段与执行阶段之间的净外力矩较小(p)。尽管在步态启动过程中保留了时空参数，但在该功能任务的关键过渡时期，低残疾的多发性硬化症患者在横切面和矢状面减少了净外部力矩，这似乎是一种保持整体姿势稳定性的代偿方式。这一发现强调了在这些平面上谨慎的旋转行为，以防止坠落的风险并保持动态稳定性。全身角动量和净外力矩是疾病功能和病情进展随访的相关参数。

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Patients with multiple sclerosis and low disability display cautious rotational behavior during gait initiation

Background

Multiple sclerosis induces locomotor impairments. The objective was to characterize the effects of Multiple Sclerosis on whole-body angular momentum control during gait initiation.

Methods

Fifteen patients with Multiple Sclerosis with Expanded Disability status scale of 2.5 and 16 healthy participants were instructed to perform gait initiation. Spatiotemporal parameters, whole-body angular momentum, net external moment about the body's center of mass and its components were calculated by using a 3D motion capture system and two force plates.

Findings

Patients with Multiple Sclerosis had a significantly smaller whole-body angular momentum range during the double support phase of gait initiation in the transversal plane (p = 0.011), and smaller net external moment at the transition between the initial double support phase and the execution phase in the sagittal plane (p = 0.013). In the transversal plane, patients with Multiple Sclerosis had a smaller net external moment during the double support phase (p = 0.024) and between the double support phase and the execution phase (p < 0.001).

Interpretation

Despite preserved spatiotemporal parameters during gait initiation, patients with Multiple Sclerosis with low disability had reduced net external moments in the transversal and sagittal planes during the critical transitional period of this functional task, which appeared as a compensatory modality to preserve global postural stability. This finding highlights the cautious rotational behaviors in these planes to prevent the risk of falling and preserve dynamic stability. Whole-body angular momentum and net external moment are relevant parameters for functional and disease progression follow-up of the disease.

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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.