与健康受试者相比,MS (PwMS)患者在步态中明显减少蹬离和脚趾间隙。这些缺陷可能是由于踝关节神经运动控制的改变造成的。为了优化PwMS的康复干预,一个关键步骤是评估以肌肉协同为代表的神经运动控制是否以及如何随着康复而改善。在本研究中,我们调查了PwMS患者步态中踝关节运动控制和相关生物力学参数的变化,步态康复后随着速度的增加而发生。收集11名PwMS患者(年龄50.3±11.1岁;EDSS 5.2 + 1.2)在20节高强度跑步机训练前(T0)和之后(T1)以自己选择的速度在地上行走。肌肉协同利用非负矩阵分解提取。根据LAMB算法计算步态参数。皮尔逊相关系数用于评价PwMS和HS之间运动模块的相似性。为了评估代表踝关节神经运动控制的远端模块(前推进模块(FPM)和地面间隙模块(GCM))的激活差异,每个模块的激活时间被集成到步态周期的100%以上,激活百分比指数(API)被分为六个阶段计算。 Ten age matched HS provided two separate speed-matched normative datasets for T0 and T1. For speed independent comparison for the PwMs scores were calculated for all their gait variables. In PwMS velocity increased significantly from T0 to T1 (0.74-0.90 m/s, < 0.05). The activation profiles (API) of FPM and GCM of PwMS improved in pre-swing ( < 0.05): FPM (Mean [95% CI] [%]: T0: 12.5 [5.7-19.3] vs. T1: 9.0 [2.7-15.3]); GCM (T0: 26.7 [18.2-35.3] vs. T1: 24.5 [18.2-30.7]). This was associated with an increase in toe clearance (80.3 to 103.6 mm, < 0.05) and a higher ankle power peak in pre-swing (1.53-1.93 W/kg, < 0.05). Increased gait speed of PwMS after intensive gait training was consistent with improvements in spatio-temporal gait parameters. The most important finding of this study was the re-organization of distal leg modules related to neurophysiological changes induced by rehabilitation. This was associated with an improved ankle performance.
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