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Rearfoot-forefoot profile defined by vertical ground reaction forces during gait is altered in patients with unilateral intermittent claudication.
Journal of Biomechanics ( IF 2.4 ) Pub Date : 2020-07-18 , DOI: 10.1016/j.jbiomech.2020.109966
Céline Guilleron 1 , Sylvain Durand 2 , Waël Maktouf 2 , Samir Henni 3 , Pierre Abraham 4 , Bruno Beaune 2
Affiliation  

Intermittent Claudication due to Peripheral Arterial Disease (PAD-IC) induces ischemic pain in exercising muscles, and therefore impaired gait. In a pathological context, the analysis of the Vertical component of Ground Reaction Force (VGRF) is frequently used to describe gait pattern. This paper aims to define gait profiles according to the relative difference between peaks of VGRF; a Rearfoot and a Forefoot profile revealing a more loading or push-off strategy. We evaluated 70 participants (24 with unilateral disease (Unilat-IC), 22 with bilateral disease (Bilat-IC) and 24 Controls) during a walk test on an instrumented treadmill. Results indicate that Unilat-IC patients present a Rearfoot-profile in both legs during the pain-free gait period, likely to stabilize their gait. With the onset and increase of pain, the asymptomatic leg changes for a Forefoot-profile. This asymmetrical pattern suggests that a compensatory mechanism occurred to unload the symptomatic (painful) leg, possibly creating an imbalance. In Bilat-IC and Controls subjects, a Forefoot-profile is found, with a symmetrical pattern. However, there is a trend for lower propulsive capacity in case of Bilat-IC due to ischemic pain, but patients did not have the ability to compensate as in Unilat-IC. Therefore, Bilat-IC should not be considered as a “double” Unilat-IC. This study highlights the existence of gait profiles based on VGRF in PAD-IC patients. These profiles are dependent on the type of disease. Analysis of these gait profiles can 1) provide a simple way to identify gait alterations and 2) participate in improving physical rehabilitation strategies in PAD-IC patients.



中文翻译:

单侧间歇性lau行患者步态中垂直地面反作用力定义的后脚-前脚轮廓发生变化。

由于周围动脉疾病(PAD-IC)引起的间歇性lau行会在锻炼肌肉时引起局部缺血性疼痛,因此会影响步态。在病理情况下,地面反作用力的垂直分量(VGRF)的分析通常用于描述步态模式。本文旨在根据VGRF峰之间的相对差异定义步态图。后脚和前脚的轮廓揭示了更多的加载或下垂策略。在仪器式跑步机上进行步行测试时,我们评估了70名参与者(24名患有单侧疾病(Unilat-IC),22名患有双侧疾病(Bilat-IC)和24名对照组)。结果表明,Unilat-IC患者在无痛步态期间双腿都出现了后脚轮廓,可能会稳定步态。随着疼痛的发作和加剧,无症状的腿改变为前脚轮廓。这种不对称模式表明发生了一种补偿机制,以减轻有症状的(痛苦的)腿的负担,这可能造成不平衡。在Bilat-IC和控制对象中,发现前脚掌轮廓具有对称模式。但是,由于缺血性疼痛,Bilat-IC的推进能力有降低的趋势,但是患者没有Unilat-IC那样的补偿能力。因此,不应将Bilat-IC视为“双重” Unilat-IC。这项研究突出了PAD-IC患者基于VGRF的步态分布。这些概况取决于疾病的类型。这些步态分布图的分析可以1)提供识别步态改变的简单方法,2)参与改善PAD-IC患者的身体康复策略。

更新日期:2020-07-18
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