بیومکانیک شروع و پایان راه‌ رفتن با تأکید بر ابزار، سطح و اختلالات اسکلتی-عضلانی و عصبی: مقاله مروری سیستماتیک

نوع مقاله : مقاله مروری

نویسندگان

1 دکتری بیومکانیک ورزشی، گروه آسیب‎شناسی و بیومکانیک ورزشی، دانشکده تربیت ‏بدنی و علوم ورزشی، دانشگاه خوارزمی، تهران، ایران

2 استاد تمام گروه بیومکانیک و آسیب‌شناسی ورزشی، دانشکده تربیت‌بدنی و علوم ورزشی و پژوهشکده علوم حرکتی ، دانشگاه خوارزمی، تهران، ایران

چکیده

مقدمه و اهداف
یکی از رایج‌ترین فعالیت‌های حرکتی انسان راه ‌رفتن است که جزئی لاینفک از بسیاری از فعالیت‌های روزمره و ورزش‌های رقابتی و گروهی می‌باشد. شروع راه ‌رفتن، اولین گام پس از تغییر حالت از وضعیت ایستا به پویا و پایان راه ‌رفتن آخرین گام پیش از تغییر حالت از وضعیت پویا به ایستا می‌باشد. با توجه به اینکه نوع سطح و پوششی که فعالیت بدنی روی آن انجام می‏شود، همچنین سن، بیماری‎ها و اختلالات اسکلتی-عضلانی افراد در عملکرد بیومکانیکی آنها تغییر ایجاد می‏کند، به ‌نظر می‌رسد الگوی فعالیت عضلانی و پارامترهای بیومکانیکی شروع و پایان راه ‌رفتن نه‏تنها متفاوت از راه ‏رفتن معمولی است، بلکه تحت تاثیر شرایط فردی و سطوح مختلفی که حرکت روی آن صورت می‎پذیرد نیز تغییر می­کند. از سویی دیگر، عدم تعادل و سقوط افراد اغلب در شروع و پایان راه‌ رفتن اتفاق می‌افتد، شناخت پارامترهای کینماتیکی و کینتیکی شروع و پایان راه‌ رفتن اطلاعات سودمندی را جهت شناخت اختلالات این فاز از راه‌ رفتن و آسیب‌شناسی و اصلاح عملکرد فراهم می‌کند. هدف از مطالعه حاضر، مروری بر پژوهش‌هایی است که از اواخر قرن بیستم تاکنون پیرامون متغیرهای بیومکانیکی شروع و پایان راه‌ رفتن در شرایط و گروه‎های مختلف انجام شده است.
مواد و روش ­ها
جستجوی مقالات در پایگاه‌های اطلاعاتی معتبر نظیر  Pub Med, Science Direct, Mendelyبا جستجوی کلمات کلیدی انجام گرفت. بیش از 300 مقاله پیرامون الگوی فعالیت عضلانی و پارامترهای بیومکانیکی شروع و پایان راه‏ رفتن یافت شد که پس از مطالعه و حذف مقالات با نتایج مشابه و مقالات مربوط به پروتکل‌های درمانی از مجموع مقالات یافت­شده، بیش از 40 مقاله که به ‌طور مستقیم مرتبط با موضوع مورد مطالعه بود، بررسی شد.
یافته­ ها
از مجموع مقالات یافت­شده، پژوهش‎های متعددی پیرامون شروع و پایان نیمه‌ارادی راه رفتن، شروع و پایان راه‌ رفتن بر سطوح مختلف و شروع و پایان راه‎ رفتن در گروه‌های سنی مختلف و یا افراد مبتلا به بیماری‌های عصبی-عضلانی یافت شد.
نتیجه­ گیری
با توجه به مطالعات انجام­شده می‌توان گفت اگرچه استراتژی‌های حرکتی متفاوتی در شروع راه‌ رفتن با سرعت‌های کم و زیاد به ‌کار گرفته می‎شود و همواره گروه جوان و سالمند الگوی فعالیت عضلانی متفاوتی را در فازهای مختلف در شروع راه‌ رفتن به ‏کار می‏گیرند، ورزشکاران و افراد فعال به ‏دلیل برخورداری از قدرت عضلانی بهتر و زمان عکس‌العمل کوتاه‌تر از مکانیسم‌های جبران برای پیشگری از سقوط و بروز آسیب بهره می‏برند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Biomechanical Variables of Gait Initiation and Gait Termination with Emphasis on Instruments, Floors, and Musculoskeletal Disorders: A Systematic Review

نویسندگان [English]

  • Nesa Keshavarz Moghadam 1
  • Haider Sadeghi 2
1 PhD in Sport Biomechanics, Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
2 Full Professor, Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences and Research Institute of Movement Science, Kharazmi University, Tehran, Iran
چکیده [English]

Background and Aims: One of the most commonly used human movements that plays an essential part of many daily activities and competitive or group sports is gait. Gait initiation is the first step after changing from static to dynamic status of walking and gait termination is the last step before changing from dynamic to static status. By accepting the effect of the properties of floor coverings, people's age, diseases, and musculoskeletal disorders on biomechanical parameters of human's movement, it seems that not only the pattern of muscular activity and the biomechanical parameters of gait initiation and gait termination are different from the routine gait, but these variables are influenced by individual's conditions and various surfaces on which people move on, too. On the other hand, people's imbalance and fall often occur at gait initiation or gait termination. Identifying kinematic and kinetic parameters of gait initiation and gait termination provides useful information to recognize the disturbances of this phase of gait, its pathology, and performance correction. The aim of the present study is reviewing studies carried out since the end of the twentieth century on biomechanical variables of gait initiation and gait termination in different groups and different conditions.
Materials and Methods: Searching articles was done from databases including PubMed, ScienceDirect, and Mendely, using “gait initiation, gait termination, kinematics, and kinetics” keywords. More than 300 articles on the pattern of muscle activity and biomechanical parameters of gait initiation and gait termination were found. After studying and deleting articles with similar results and articles on therapeutic protocols from the total number of articles, more than 40 articles that were directly related to the subject matter were studied.
Results: From among the papers located, several studies were about planned and unplanned gait initiation or gait termination, gait initiation or gait termination on different floor coverings, in various age groups or people with musculoskeletal disorders.
Conclusion: According to the articles studied, it can be stated that different motor strategies are used at gait initiation at low and high velocities and the young and old groups always uses different muscle activity patterns in different phases of gait initiation. It seems that athletes and active people benefit from better muscle strength and shorter reaction times to prevent collapse and injury making use of compensatory mechanisms.

کلیدواژه‌ها [English]

  • Gait initiation
  • Gait termination
  • Kinematics
  • Kinetics
  1. Mousavi SK, Sadeghi H, TabatabaiiGhomsheh SF. Functional Comparison between Kinematic Parameters in Voluntary and Involuntary Gait Initiation in Active Male. Journal of Modern Rehabilitation. 2013;7[3]:62-8.##
  2. Teymourian B, Sadeghi H, Shariatzade joneydi M. Comparison of Ground Reaction Forces, Center of Pressure and Body Center of Mass Changes in the Voluntary, Semi-Voluntary and Involuntary Gait Termination in Healthy Young Men. Journal of Sport Biomechanics. 2016;1[3]:43-52. ##
  3. Alton F, Baldey L, Caplan S, Morrissey MC. A kinematic comparison of overground and treadmill walking. Clinical Biomechanics. 1998;13[6]:434-40. ##
  4. Patchay S, Gahery Y, Serratrice G. Gait initiation and impairments of ground reaction forces as illustrated in old age by `La marche à petits pas'. Neuroscience Letters. 1997;236[3]:143-6. ##
  5. Delval A, Tard C, Defebvre L. Gait initiation and attention. Neurophysiologie Clinique/Clinical Neurophysiology. 2017;47[3]:197-8. ##
  6. Ikeuchi H, Ohira T, Higuchi K, Komatsu Y, Yamada K .Analisys of COP Fluctuation in Gait Initiation among Normal, Disable and Elder. Journal of Biomechanics. 2007;40:S519. ##
  7. Khorramymehr S, Yasrebi B, Leilnahari K. P023 Gait initiation analysis of a patient with Huntington's disease using wearable sensors for acceleration: a case study. Gait & Posture. 2008;28:S63. ##
  8. Wentink EC, Schut VGH, Prinsen EC, Rietman JS, Veltink PH. Detection of the onset of gait initiation using kinematic sensors and EMG in transfemoral amputees. Gait & Posture. 2014;39[1]:391-6. ##
  9. Isaias IU, Dipaola M, Marzegan A, Frigo CA. The center of pressure—Center of mass vector as a parameter to characterize gait initiation impairments. Gait & Posture. 2014;40:S10-S1. ##

10. Prinsen EC, Nederhand MJ, Rietman HJ. Decoupling the extrapolated centre of mass [XCoM] and centre of pressure [CoP] during gait initiation. Introduction of a new variable. Gait & Posture. 2015;42:S75-S6. ##

11. Khanmohammadi R, Talebian S, Hadian MR, Olyaei G, Bagheri H. Characteristic muscle activity patterns during gait initiation in the healthy younger and older adults. Gait & Posture. 2016;43:148-53. ##

12. Rajachandrakumar R, Fraser JE, Schinkel-Ivy A, Inness EL, Biasin L, Brunton K, et al. Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke. Gait & Posture. 2017;52:325-31. ##

13. Lu C, Amundsen HuffmasterSL, Harvey JC, MacKinnon CD. Anticipatory postural adjustment patterns during gait initiation across the adult lifespan. Gait & Posture. 2017;57:182-7. ##

14. Mizusawa H, Jono Y, Iwata Y, Kinoshita A, Hiraoka K. Processes of anticipatory postural adjustment and step movement of gait initiation. Human Movement Science. 2017;52:1-16. ##

15. Shulman D, Spencer A, Vallis LA. Age-related alterations in reactive stepping following unexpected mediolateral perturbations during gait initiation. Gait & Posture. 2018;64:130-4. ##

16. Stansfield B, Hawkins K, Adams S, Church D. Spatiotemporal and kinematic characteristics of gait initiation across a wide speed range. Gait & Posture. 2018;61:331-8. ##

17. Lynch J, Robertson DGE. BIOMECHANICS OF PLANNED GAIT TERMINATION. Journal of Biomechanics. 2007;40:S500##

18. Menant JC, Steele JR, Menz HB, Munro BJ, Lord SR. Rapid gait termination: Effects of age, walking surfaces and footwear characteristics. Gait & Posture. 2009;30[1]:65-70. ##

19. Wikstrom EA, Hass CJ. Gait termination strategies differ between those with and without ankle instability. Clinical Biomechanics. 2012;27[6]:619-24##

20. Buckley TA, Munkasy BA, Tapia-Lovler TG, Wikstrom EA. Altered gait termination strategies following a concussion. Gait & Posture. 2013;38[3]:549-5. ##

21. Cameron D, Murphy A, Morris ME, Raghav S, Iansek R. Planned stopping in people with Parkinson. Parkinsonism & Related Disorders. 2010;16[3]:191-6. ##

22. Ridge ST, Henley J, Manal K, Miller F, Richards JG. Kinematic and kinetic analysis of planned and unplanned gait termination in children. Gait & Posture. 2013;37[2]:78-82. ##

23. Ryckewaert G, Delval A, Bleuse S, Blatt JL, Defebvre L. Biomechanical mechanisms and centre of pressure trajectory during planned gait termination. NeurophysiologieClinique/Clinical Neurophysiology. 2014;44[2]:227-33. ##

24. Roeing KL, Moon Y, Sosnoff JJ. Unplanned gait termination in individuals with multiple sclerosis. Gait & Posture. 2017;53:168-72. ##

25. Ridge ST, Henley J, Manal K, Miller F, Richards JG. Biomechanical analysis of gait termination in 11–17year old youth at preferred and fast walking speeds. Human Movement Science. 2016;49:178-85. ##

26. Watt JR, Franz JR, Jackson K, Dicharry J, Riley PO, Kerrigan DC. A three-dimensional kinematic and kinetic comparison of overground and treadmill walking in healthy elderly subjects. Clinical Biomechanics. 2010;25[5]:444-9. ##

27. Frigo C, Crenna P. Multichannel SEMG in clinical gait analysis: A review and state-of-the-art. Clinical Biomechanics. 2009;24[3]:236-45. ##

28. Bovi G, Rabuffetti M, Mazzoleni P, Ferrarin M. A multiple-task gait analysis approach: Kinematic, kinetic and EMG reference data for healthy young and adult subjects. Gait & Posture.2011;33[1]:6-13. ##

29. Jian Y, Winter DA, Ishac MG, Gilchrist L. Trajectory of the body COG and COP during initiation and termination of gait. Gait & Posture. 1993;1[1]:9-22. ##

30. Tirosh O, Sparrow WA. Age and walking speed effects on muscle recruitment in gait termination. Gait & Posture. 2005;21[3]:279-88. ##

31. Perry SD, Santos LC, Patla AE. Contribution of vision and cutaneous sensation to the control of centre of mass [COM] during gait termination. Brain Research. 2001;913[1]:27-34. ##

32. O'Kane FW, McGibbonCA, Krebs DE. Kinetic analysis of planned gait termination in healthy subjects and patients with balance disorders. Gait & Posture. 2003;17[2]:170-9. ##

33. Cesar GM, Sigward SM. Dynamic stability during running gait termination: Differences in strategies between children and adults to control forward momentum. Human Movement Science. 2015;43:138-45. ##

34. Cesar GM, Sigward SM. Dynamic stability during running gait termination: Predictors for successful control of forward momentum in children and adults. HumanMovement Science. 2016;48:37-43. ##

35. Bishop M, Brunt D, Marjama-Lyons J. Do people with Parkinson's disease change strategy during unplanned gait termination? Neuroscience Letters. 2006;397[3]:240-4. ##

36. Wearing SC, Reed LF, Urry SR. Agreement between temporal and spatial gait parameters from an instrumented walkway and treadmill system at matched walking speed. Gait & Posture. 2013;38[3]:380-4. ##

37. Tulchin K, Orendurff M, Karol L. A comparison of multi-segment foot kinematics during level overground andtreadmill walking. Gait & Posture. 2010;31[1]:104-8. ##

38. Radmehr G, Mazaheri R, Sanjari MA, Halabchi F, Mansournia MA. Comparison of activation pattern of selected trunk muscles during over ground and treadmill walking. Modern Rehabilitation. 2013;6[4]. ##

39. Chockalingam N, Chatterley F, Healy AC, Greenhalgh A, Branthwaite HR. Comparison of pelvic complex kinematics during treadmill and overground walking. Archives of physical medicine and rehabilitation. 2012;93[12]:2302-8. ##

40. Vieira MF, de Brito AA, Lehnen GC, Rodrigues FB. Center of pressure and center of mass behavior during gait initiation on inclined surfaces: A statistical parametric mapping analysis. Journal of Biomechanics. 2017;56:10-8. ##

41. Riley PO, Paolini G, Della Croce U, Paylo KW, KerriganDC. A kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. Gait & Posture. 2007;26[1]:17-24. ##

42. Alfuth M. Textured and stimulating insoles for balance and gait impairments in patients with multiple sclerosis and Parkinson’s disease: A systematic review and meta-analysis. Gait & Posture. 2017;51:132-41. ##