肌肉运动生物谐振规律的前驱研究
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摘要
目的:
本研究以正常人、下肢弛缓性瘫痪和下肢痉挛性瘫痪患者作为研究模型,探讨人体肌肉运动生物谐振规律,并分析康复干预对生物谐振状态的作用。
对象与方法:
对象:
研究一:肌肉运动生物谐振规律
正常肌肉模型:正常青少年男性在校中学生10名,身体健康,无任何步行障碍以及各个系统疾病,年龄16±2岁,身高1.73±0.1m,体重56.1±7kg。
肌肉麻痹模型:中学在校男性儿麻患者12名,有步行障碍,可扶拐独立步行,但无其它系统疾病,年龄17±1岁,身高1.68±4.6m,体重52.5±5.4kg。
肌肉痉挛模型:脑损伤后偏瘫患者10名,其中脑外伤4例、脑卒中后6例,年龄48±8岁,身高1.70±0.3m,体重70.5±9.5kg。均有典型下肢伸肌痉挛模式,均具备步行200米的能力。
研究二:康复干预对生物谐振规律的影响
矫形器干预的研究:股四头肌肌力2级的儿麻患者膝不稳组,年龄16.7±0.7岁,身高1.63±0.8m,体重50.9±7kg。与其年龄(16.7±0.7岁)相匹配的10名健康组为对照,分析不同类型的矫形器(AFO、KAFO)对步行效率的影响。
方法:
步态分析:采用美国Motion Analysis公司远红外线三维步态分析系统,包括6台红外摄像机、两个Kistler测力平台、8道动态肌电图。
主要指标:采用步态分析参数的时间一空间参数分析自然步态、慢速以及快速步行的效率。
氧价测定:采用K4b2便携式遥测气体分析系统(意大利Cosmed公司)。主要指标:氧价。
测定方案:分别测定自然步频、慢速(80%自然步频)以及快速(120%自然步频)步频的步行效率和步态指标。测试者充分暴露身体各个主要关节点,采用红外反光球固定在关节处,通过测定自由行走的运动学分析,得出自然步行的步频,然后分别推算80%与120%的步频。采用节律器标定步频,受试者按照固定音律节拍行走,反复2次适应后进行正式测定。同时进行气体代谢测定,并推算氧价。
结果
研究一:肌肉运动生物谐振规律
正常肌肉模型:正常男性青少年中学生自然步频、慢速与快速步频(steps/min)分别为107.6±1.8、85.8±7.5和128.6±10.5;步速(m/min)分别为74.9±9.4、57.4±7.8和86.8±9.3。慢速与快速的步频与步速分别同自然步频两两比较均存在显著意义(p＜0.001)。耗氧量(ml/min/kg)分别为12.7±4.1、17.5±3.8和18.1±3.5,慢速与快速的耗氧量分别同自然步频比较均出现增加趋势(p＜0.01);氧价(ml/m/kg)分别为0.140±0.011、0.193±0.049和0.192±0.035,慢速与快速的氧价分别同自然步频比较呈现显著性升高(p＜0.05)。
肌肉麻痹模型:儿麻患者自然步频、慢速与快速步频(steps/min)分别为101.3.6±8.5、80.4±8.5和121.1±9.9;三组步速(m/min)分别为65.5±8.7、53.04±5.9、74.3±9.5,快慢二组与自然组比较结果同正常组(p＜0.001)。耗氧量(ml/min/kg)分别为15.2±3.6、20.76±4.3和21.5±6.2,同自然组的比较显著增加(p＜0.01);氧价(ml/m/kg)分别为0.231±0.043、0.291±0.061、和0.288±0.072,快慢组氧价较自然步频组呈现上升趋势(p＜0.05)。
肌肉痉挛模型:偏瘫患者自然步频、慢速与快速步频(steps/min)分别为88.9±15.7、71.9±12.8和106.1±19.0;步速(m/min)分别为33.7±9.5、25.4±4.9和37.5±10.9,慢速与快速步频组分别与自然步频组的两两比较意义显著(p＜0.05);三组耗氧量(ml/min/kg)分别为9.3±1.1、9.2±1.1和9.7±1.0;氧价(ml/m/kg)分别为0.283±0.087、0.350±0.081和0.301±0.082。快慢步频组与自然步频组的耗氧量与氧价两两比较均未出现显著增加(p＞0.05)。
研究二:康复干预对肌肉运动生物谐振的影响
矫形器干预的研究:儿麻患者膝不稳组在使用踝足矫形器(AFO)时的氧价为0.264±0.049 ml/m/kg,明显低于膝不稳组使用膝踝足矫形器(KAFO)和不使用矫形器的氧价(P＜0.01),膝不稳组在三种情况下的氧价明显大于健康组(P＜0.01)。
结论:
自然步频的氧价最低,能量代谢产能效率最高,提示人体存在固有肌肉运动谐振规律。肌肉谐振频率干预,包括改变动作频率、取消肌肉谐振作用和肌肉谐振频率过高或紊乱,都导致能量消耗增加,代谢效率降低。下肢瘫痪患者AFO的康复干预可以改善生物谐振频率,提高步行效率。
Objective:
The aim of this study was to explore the effect of bio-resonance on walking efficiency in normal youth,poliomyelitis sequela and hemiplegia as well as the effect of rehabilitation measure on disturbance of bio-resonance in polio patients.
Subjects and Methods:
Subjects Normal muscle model:Ten young male participants were involved in this study,average 16.2±2ys,mean height 1.73±0.1m and mean weight 56.1±7kg.
Muscle flaccid paralysis model:Twelve young male students with poliomyelitis sequela were average 17±1ys,mean height 1.68±4.6m and mean weight 52.5±5.4kg.
Muscle spasticity model:Ten hemiplegic participants were average 43.6±13.7ys,mean height 1.7±4.2 m and mean weight 70.5±9.5kg.
Rehabilitation intervention model:Another ten polio participants were average 16.7±0.7ys,mean height 163.3±7.5m and mean weight 51.0±7.0kg.All clients with quadriceps femoris muscle strength measured grade 2 in manual muscle testing(MMT)were selected for the knee-joint-instability group.Ten age-matched normal subjects were selected for the healthy group.Oxygen cost and gait analysis were measured with the knee-joint-instability group performing free walking under three conditions:with KAFO,AFO and barefoot.The healthy group undertook free walking without orthosis.
Methods The time-space parameters were collected by Motion Analysis System and oxygen cost was obtained by a Cosmed K4b2 portable gas analysis system.Meanwhile,the self-selected,comfortable walking frequency was recorded through three dimensional gait analysis system.All participants walked according to 80%(lower speed)and 120%(higher speed)comfortable walking frequency.
Results:
The comfortable walking frequency in normal subjects was 107.6±1.8 steps/min.Eighty percent and 120%comfortable walking frequency were 85.8±7.5 s/min and 128.6±10.5steps/min.The comparison of oxygen consumption in three conditions were significantly different(p＜0.01),and the oxygen cost(ml/m/kg)were 0.140±0.011, 0.193±0.049 and 0.192±0.035,respectively.Oxygen cost of two different walking frequency had significant increase(p＜0.05).
Also,the comfortable walking frequency in Poliomyelitis was 101.3±8.5 steps/min.Low speed and high speed walking frequency were 0.42±8.5 s/min and 121.1±10.0steps/min(p＜0.001).The walking speed(m/min)was 65.5±8.1,53.4±5.2 and 74.5±9.5(p＜0.001).The comparison of oxygen consumption in three conditions were significantly different(p＜0.01),and the oxygen cost was lowest(0.23±0.04 ml/m/kg) in nature walking frequency(p＜0.05).
However,the comfortable walking frequency was 107.6±1.8 steps/min in patients with hemiplegia.Low speed and high speed walking frequency were 85.8±7.5steps/min and 128.6±10.5steps/min.The comparison of oxygen consumption in three conditions were not significantly different(p＞0.05),and the oxygen cost(ml/m/kg)were 0.283±0.087,0.350±0.081 and 0.301±0.082,respectively.Oxygen cost of different walking frequency had not significant difference(p＞0.05).
At last,the oxygen cost(0.264±0.049 ml/m/kg)is significantly reduced when walking with AFO compared to wearing KAFO and without any orthosis(p＜0.01)in the knee-joint-instability group.The oxygen cost decreased in the health group compared with the knee-joint-instability group walking with the three conditions(p＜0.01).
Conclusions:
There is an inheritate mechanism of bio-resonance on human walking,reflected by the lowest oxygen cost with nature walking rhythm. The change of walking rhythm may result in increase energy expenditure and decrease of work efficiency.
The rehabilitation intervention by AFO can enhance walking efficiency by improving the walking rhythm,which is the sign for recovery of bio-resonance.
本研究以正常人、下肢弛缓性瘫痪和下肢痉挛性瘫痪患者作为研究模型,探讨人体肌肉运动生物谐振规律,并分析康复干预对生物谐振状态的作用。
对象与方法:
对象:
研究一:肌肉运动生物谐振规律
正常肌肉模型:正常青少年男性在校中学生10名,身体健康,无任何步行障碍以及各个系统疾病,年龄16±2岁,身高1.73±0.1m,体重56.1±7kg。
肌肉麻痹模型:中学在校男性儿麻患者12名,有步行障碍,可扶拐独立步行,但无其它系统疾病,年龄17±1岁,身高1.68±4.6m,体重52.5±5.4kg。
肌肉痉挛模型:脑损伤后偏瘫患者10名,其中脑外伤4例、脑卒中后6例,年龄48±8岁,身高1.70±0.3m,体重70.5±9.5kg。均有典型下肢伸肌痉挛模式,均具备步行200米的能力。
研究二:康复干预对生物谐振规律的影响
矫形器干预的研究:股四头肌肌力2级的儿麻患者膝不稳组,年龄16.7±0.7岁,身高1.63±0.8m,体重50.9±7kg。与其年龄(16.7±0.7岁)相匹配的10名健康组为对照,分析不同类型的矫形器(AFO、KAFO)对步行效率的影响。
方法:
步态分析:采用美国Motion Analysis公司远红外线三维步态分析系统,包括6台红外摄像机、两个Kistler测力平台、8道动态肌电图。
主要指标:采用步态分析参数的时间一空间参数分析自然步态、慢速以及快速步行的效率。
氧价测定:采用K4b2便携式遥测气体分析系统(意大利Cosmed公司)。主要指标:氧价。
测定方案:分别测定自然步频、慢速(80%自然步频)以及快速(120%自然步频)步频的步行效率和步态指标。测试者充分暴露身体各个主要关节点,采用红外反光球固定在关节处,通过测定自由行走的运动学分析,得出自然步行的步频,然后分别推算80%与120%的步频。采用节律器标定步频,受试者按照固定音律节拍行走,反复2次适应后进行正式测定。同时进行气体代谢测定,并推算氧价。
结果
研究一:肌肉运动生物谐振规律
正常肌肉模型:正常男性青少年中学生自然步频、慢速与快速步频(steps/min)分别为107.6±1.8、85.8±7.5和128.6±10.5;步速(m/min)分别为74.9±9.4、57.4±7.8和86.8±9.3。慢速与快速的步频与步速分别同自然步频两两比较均存在显著意义(p＜0.001)。耗氧量(ml/min/kg)分别为12.7±4.1、17.5±3.8和18.1±3.5,慢速与快速的耗氧量分别同自然步频比较均出现增加趋势(p＜0.01);氧价(ml/m/kg)分别为0.140±0.011、0.193±0.049和0.192±0.035,慢速与快速的氧价分别同自然步频比较呈现显著性升高(p＜0.05)。
肌肉麻痹模型:儿麻患者自然步频、慢速与快速步频(steps/min)分别为101.3.6±8.5、80.4±8.5和121.1±9.9;三组步速(m/min)分别为65.5±8.7、53.04±5.9、74.3±9.5,快慢二组与自然组比较结果同正常组(p＜0.001)。耗氧量(ml/min/kg)分别为15.2±3.6、20.76±4.3和21.5±6.2,同自然组的比较显著增加(p＜0.01);氧价(ml/m/kg)分别为0.231±0.043、0.291±0.061、和0.288±0.072,快慢组氧价较自然步频组呈现上升趋势(p＜0.05)。
肌肉痉挛模型:偏瘫患者自然步频、慢速与快速步频(steps/min)分别为88.9±15.7、71.9±12.8和106.1±19.0;步速(m/min)分别为33.7±9.5、25.4±4.9和37.5±10.9,慢速与快速步频组分别与自然步频组的两两比较意义显著(p＜0.05);三组耗氧量(ml/min/kg)分别为9.3±1.1、9.2±1.1和9.7±1.0;氧价(ml/m/kg)分别为0.283±0.087、0.350±0.081和0.301±0.082。快慢步频组与自然步频组的耗氧量与氧价两两比较均未出现显著增加(p＞0.05)。
研究二:康复干预对肌肉运动生物谐振的影响
矫形器干预的研究:儿麻患者膝不稳组在使用踝足矫形器(AFO)时的氧价为0.264±0.049 ml/m/kg,明显低于膝不稳组使用膝踝足矫形器(KAFO)和不使用矫形器的氧价(P＜0.01),膝不稳组在三种情况下的氧价明显大于健康组(P＜0.01)。
结论:
自然步频的氧价最低,能量代谢产能效率最高,提示人体存在固有肌肉运动谐振规律。肌肉谐振频率干预,包括改变动作频率、取消肌肉谐振作用和肌肉谐振频率过高或紊乱,都导致能量消耗增加,代谢效率降低。下肢瘫痪患者AFO的康复干预可以改善生物谐振频率,提高步行效率。
Objective:
The aim of this study was to explore the effect of bio-resonance on walking efficiency in normal youth,poliomyelitis sequela and hemiplegia as well as the effect of rehabilitation measure on disturbance of bio-resonance in polio patients.
Subjects and Methods:
Subjects Normal muscle model:Ten young male participants were involved in this study,average 16.2±2ys,mean height 1.73±0.1m and mean weight 56.1±7kg.
Muscle flaccid paralysis model:Twelve young male students with poliomyelitis sequela were average 17±1ys,mean height 1.68±4.6m and mean weight 52.5±5.4kg.
Muscle spasticity model:Ten hemiplegic participants were average 43.6±13.7ys,mean height 1.7±4.2 m and mean weight 70.5±9.5kg.
Rehabilitation intervention model:Another ten polio participants were average 16.7±0.7ys,mean height 163.3±7.5m and mean weight 51.0±7.0kg.All clients with quadriceps femoris muscle strength measured grade 2 in manual muscle testing(MMT)were selected for the knee-joint-instability group.Ten age-matched normal subjects were selected for the healthy group.Oxygen cost and gait analysis were measured with the knee-joint-instability group performing free walking under three conditions:with KAFO,AFO and barefoot.The healthy group undertook free walking without orthosis.
Methods The time-space parameters were collected by Motion Analysis System and oxygen cost was obtained by a Cosmed K4b2 portable gas analysis system.Meanwhile,the self-selected,comfortable walking frequency was recorded through three dimensional gait analysis system.All participants walked according to 80%(lower speed)and 120%(higher speed)comfortable walking frequency.
Results:
The comfortable walking frequency in normal subjects was 107.6±1.8 steps/min.Eighty percent and 120%comfortable walking frequency were 85.8±7.5 s/min and 128.6±10.5steps/min.The comparison of oxygen consumption in three conditions were significantly different(p＜0.01),and the oxygen cost(ml/m/kg)were 0.140±0.011, 0.193±0.049 and 0.192±0.035,respectively.Oxygen cost of two different walking frequency had significant increase(p＜0.05).
Also,the comfortable walking frequency in Poliomyelitis was 101.3±8.5 steps/min.Low speed and high speed walking frequency were 0.42±8.5 s/min and 121.1±10.0steps/min(p＜0.001).The walking speed(m/min)was 65.5±8.1,53.4±5.2 and 74.5±9.5(p＜0.001).The comparison of oxygen consumption in three conditions were significantly different(p＜0.01),and the oxygen cost was lowest(0.23±0.04 ml/m/kg) in nature walking frequency(p＜0.05).
However,the comfortable walking frequency was 107.6±1.8 steps/min in patients with hemiplegia.Low speed and high speed walking frequency were 85.8±7.5steps/min and 128.6±10.5steps/min.The comparison of oxygen consumption in three conditions were not significantly different(p＞0.05),and the oxygen cost(ml/m/kg)were 0.283±0.087,0.350±0.081 and 0.301±0.082,respectively.Oxygen cost of different walking frequency had not significant difference(p＞0.05).
At last,the oxygen cost(0.264±0.049 ml/m/kg)is significantly reduced when walking with AFO compared to wearing KAFO and without any orthosis(p＜0.01)in the knee-joint-instability group.The oxygen cost decreased in the health group compared with the knee-joint-instability group walking with the three conditions(p＜0.01).
Conclusions:
There is an inheritate mechanism of bio-resonance on human walking,reflected by the lowest oxygen cost with nature walking rhythm. The change of walking rhythm may result in increase energy expenditure and decrease of work efficiency.
The rehabilitation intervention by AFO can enhance walking efficiency by improving the walking rhythm,which is the sign for recovery of bio-resonance.
引文
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25. Waters R, Mulroy S. The energy expenditure of normal and pathologic gait [J]. Gait Posture ,1999,9:207-231
1.励建安,孟殿怀,步态分析的临床应用.中华物理医学与康复杂志,2006,28(7):500-503
2.Eva Mattsson,Energy cost of level walking[J],Scandinavian Journal of Rehabilitation Medicine,Supplement No.23,1989
3.Bereket S.Effects of Anthropometric parameters and stride frequence on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005;45(2):152-16.
4.Bowen TR,Cooley SR et al.A method for normalization of oxygen cost and consumption in normal children while walking[J].J Pediatr Orthop,1998;18(5):589-593
5.Laughlin JE,King GA et al.Validation of the COSMED K4 b2portable metabolic system International journal of sports medicine,2001;22(4):280-284.
6.Dffield R,Dawson B et al.Accuracy and reliability of a Cosmed K4b2 portable gas analysis system.J Sci Med Sport,2004;7(1):1.
1.吴莉莉,惠国华,潘敏等.生物医学领域中随机共振的理论及应用研究[J],国际生物医学工程杂志,2007,30(2):86-90
2.Hiilloskorpi HK,Pasanen ME,MG Fogellholm.Use of heart rate to predict energy expenditure from low to high activity levels[J].Int J Sports Med,2003,24(5):332-336
3.Utter,AC,Robertson RJ,Validation of the Adult OMNI Scale of Perceived Exertion for Walking/Running Exercise.[J]Med.SCI.Sports Exerc,2004,36(10):1776-1780
4.Bereket S.Effects of Anthropometric parameters and stride frequence on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005,45(2):152-16
5.Shumway CA,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams & Wilkins,1995:308-314
6.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients: efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis. Arch Phys Med Rehabil, 1996,77(11):1144-51
7. Duffy CM, Hill AE, Graham HK. The influence of flexed-knee gait on the energy cost of walking in children. Developmental medicine and child neurology, 1997,39(4):234-8
8. Waters R, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture ,1999,9:207-231
9. Kerrigan, DC. Guest editorial: aesthetics of walking. Journal Rehabilitation Research and Development,2001,38:ix-x
10． 励建安．神经疾病的步态分析[J]．中国康复医学杂志,2005, 20(4)： 304—306
11. Laughlin JE, King GA et al. Validation of the COSMED K4 b2 portable metabolic system International journal of sports medicine, 2001,22 (4): 280-284
12. Dffield R, Dawson B et al. Accuracy and reliability of a Cosmed K4b2 portable gas analysis system. J Sci Med Sport, 2004,7(1):1
13. Karim Fouad, Keir Pearson. Progress in Neurobiology, 2004,73:107-126
14. Mulder DW, Rosenbaum RA, Layton DD Jr. Late progression of poliomyelitis or forme fruste amyotrophic lateral sclerosis? Mayo ClinProc,1972,47:756-61
15. Agre JC.The role of exercise in the patient with post-polio syndrome. Ann N Y Acad Sci, 1995 May 25,753:321-34
16. Brehm MA, Nollet F, Harlaar J.Energy demands of walking in persons with postpoliomyelitis syndrome: relationship with muscle strength and reproducibility. Arch Phys Med Rehabil, 2006,87(1):136-40
17.Willen C,Stibrant Sunnerhagen K,Ekman C,Grimby G.How is walking speed related to muscle strength? A study of healthy persons and persons with late effects of polio.Arch Phys Med Rehabil,2004,85(12):1923-8
18.许光旭,卢青.步态分析在偏瘫康复评定与治疗中的作用,中国运动医学杂志,1997;16(1):29-35
19.王桂茂.中风偏瘫步态的生物力学及其运动学特征分析,中国组织工程研究与临床康复,2007;40:8169-8172
20.Suzanne Kuys,Sandra Brauer,Louise Ada,Routine physiotherapy does not induce a cardiorespiratory training effect poststroke,regardless of walking ability[J].Physiother.Res.Int,2006;11(4):219-227
21.MacKay-Lyons MJ,Makrides L.Cardiovascular stress during a contemporary stroke rehabilitation program:is the intensity adequate to induce a training effect[J]? Arch Phys Med Rehabil,2002,83:1378-83
22.许光旭.偏瘫不对称步态的生物力学研究,中国康复医学杂志,1995;10(3):97-101
23.Robinson RG et al.Two-year longitudinal study of poststroke mood disorders:Diagnosis and outcome at one and outcome at one and two years.Stroke,1987;18:837-843
1.Moss CL,Wright PT.Comparison of Three Methods of Assessing Muscle Strength and Imbalance Ratios of the Knee.J Athl Train,1993,28(1):55-58
2.励建安,王彤.康复医学.北京:科学出版社,第一版,2002:52-258.
3.Shumway CA,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams & Wilkins,1995:308-314
4.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients:efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis.Archives of physical medicine and rehabilitation,1996,77(11):1144-51
5.Duffy CM,Hill AE,Graham HK.The influence of flexed-knee gait on the energy cost of walking in children.Developmental medicine and child neurology,1997,39(4):234-8
6.Waters R,Mulroy S.The energy expenditure of normal and pathologic gait.Gait Posture.1999;9:207-231
7.Kerrigan,D.C.Guest editorial:aesthetics of walking.Journal Rehabilitation Research and Development.2001;38:ⅸ-ⅹ
8.丸山仁司.临床运动学.北京:中国中医药出版社,第三版,2002:190
9.Pretide AM.The double-labelled water method for measuring energy expenditure:technical recommendations for use in human,a consensus report by the international dietary energy consultancy working group[J].International Atomic Energy Agency Vienna,1990
10.Hilsan Taber S,Rimm EB,Stamper MJ,et al.Reproducibility and validity of a selfadministered physical activity questionnaire for male health professionals[J].Epidemiology,1996,7:81-86
11.高怀民.使用助行器械和矫形器步行训练的评估问题.现代康复,2000,4(7):966-967
12.Dffield R,Dawson B et al.Accuracy and reliability of a Cosmed K4b2 portable gas analysis system.J Sci Med Sport,2004,7(1):1
13.Laughlin JE,King GA et al.Validation of the COSMED K4 b2portable metabolic system International journal of sports medicine,2001,22(4):280-284
14.Patrick JH.The Case for gait analysis as part of the management of incomplete spinal cord injury.Spinal Cord,2003;41:479-482
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16.Baker R.Gait analysis methods in rehabilitation.Journal of neuroengineering and rehabilitation[electronic resource],2006,3:4
17.Franceschini M,Massucci M,et al.Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait.Clin Rehabil,2003,17(4):368-72
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24. Brehm MA, Nollet F, Harlaar J. Energy demands of walking in persons with postpoliomyelitis syndrome: relationship with muscle strength and reproducibility. Archives of physical medicine and rehabilitation, 2006, 87(1): 136-40
1. Jianan Li, Tong Wang. Kangfu Yixue(康复医学). Science Publicaion Company, the first ed, 2002:252-258
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1.Woo R.Plasticity:orthopedic perspective.J Child Neural,2001;16(1):47-53
2.李邦惠,任永平,蔡方成.运动疗法对痉挛性脑性瘫痪患儿运动功能发育的影响[J].中国临床康复,2004,8(18):3582
3.Fuller DA,Keenan MA,Esquenazi A,et al.The impact of instrumented gait analysis on surgical planning:treatment of spastic equinovarus deformity of the foot and ankle.Foot Ankle Int,2002,23(8):738-43
4.俞兴,徐林.中国脑性瘫痪外科10年回顾与展望[J].中国临床康复,2004,8(2):299
5.Chambers HG.Treatment of functional limitations at the knee in ambulatory children with cerebral palsy.Eur J Neurol,2001;8(Suppl 5):59-74
6.Woo R.Spasticity:orthopedic perspective.J Child Neurol,2001,16(1):47-53
1.吴莉莉,惠国华,潘敏.生物医学领域中随机共振的理论及应用研究[J],国际生物医学工程杂志,2007,30(2):86-90
2.Gammaitoni L,Hanggi P,Jung P,et al.Stochastic resonance[J]. Rev Modern Phys,1998,709(1):223-287
3.励建安,孟殿怀.步态分析的临床应用,中华物理医学与康复杂志,2006,28(7):500-503
4.陈勇.温情音乐与运动同步共振疗法最适合过劳人群[J],中国组织工程研究与临床康复,2007,11(52):10632-35
5.Utter,AC,Robertson RJ,Validation of the Adult OMNI Scale of Perceived Exertion for Walking/Running Exercise.[J]Med.SCI.Sports Exerc,2004,36(10):1776-1780
6.Bereket S.Effects of Anthropometric parameters and stride frequence on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005,45(2):152-16
7.Shumway-Cook A,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams &Wilkins,1995:308-314
8.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients:efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis.Archives of physical medicine and rehabilitation,1996,77(11):1144-51
9.Duffy CM,Hill AE,Graham HK.The influence of flexed-knee gait on the energy cost of walking in children.Developmental medicine and child neurology,1997,39(4):234-8
10.Waters R,Mulroy S.The energy expenditure of normal and pathologic gait.Gait Posture,1999,9:207-231
11.Kerrigan,DC.Guest editorial:aesthetics of walking.Journal Rehabilitation Research and Development,2001,38:ⅸ-ⅹ
12.Laughlin JE,King GA et al.Validation of the COSMED K4 b2portable metabolic system International journal of sports medicine,2001,22(4):280-284
13.Dffield R,Dawson B et al.Accuracy and reliability of a Cosmed K4b2 portable gas analysis system.J Sci Med Sport,2004,7(1):1
14.Waters R,Mulroy S.The energy expenditure of normal and pathologic gait[J].Gait Posture,1999,9:207-231
15.Nollet F,Beelen A.Submaximal exercise capacity and maximal power output in polio subjects[J].Arch Phys Med Rehabil,2001,82(12):1678-1685
16.石宗义.脊髓灰质炎后综合症流行病学调查.山东医药,1996,36(5):32
17.Mulder DW,Rosenbaum RA,Layton DD Jr.Late progression of poliomyelitis or forme fruste amyotrophic lateral sclerosis? Mayo Clin Proc,1972,47:756-61
18.Agre JC.The role of exercise in the patient with post-polio syndrome.Ann N Y Acad Sci,1995 May 25,753:321-34
19.Brehm MA,Nollet F,Harlaar J.Energy demands of walking in persons with postpoliomyelitis syndrome:relationship with muscle strength and reproducibility.Arch Phys Med Rehabil,2006 Jan,87(1):136-40
20.H.K.Hiilloskorpi,M.E.Pasanen,M.G.Fogellholm.Use of heart rate to predict energy expenditure from low to high activity levels [J].Int J Sports Med,2003,24(5):332-336
21.许光旭,卢青.步态分析在偏瘫康复评定与治疗中的作用,中国运动医学杂志,1997,16(1):29-35
22.王桂茂.中风偏瘫步态的生物力学及其运动学特征分析.中国组织工程研究与临床康复,2007,40:8169-8172
23.Kelly JO,Kilbreath SL,Davis GM,et al.Cardiorespiratory fitness and walking ability in subacute stroke patients[J].Arch Phys Med Rehabil,2003,84(12):1780-1785
24.高霞,李京平,陈刚.偏瘫患者行走能量消耗与速度的相关性[J],中国临床康复,2006,10(16):110-111
25.Rimmer JH,Wang E.Aerobic exercise training in stroke survivors [J].Top Stroke Rehabil,2005,12(1):17-30
26.Mayo NE,Wood-Dauphinee S,Ahmed S,et al.Disablement following stroke[J].Disabil Rehabil,1999,21(5-6):258-268
27.Dalakas MC.How to design a therapeutic study in patients with the post-polio syndrome.Methodological concerns and status of present therapies.Ann N Y Acad Sci,1995 May 25,753:314-20
28.励建安.神经疾病的步态分析[J].中国康复医学杂志,2005,20 (4):304-306
29.Baker R.Gait analysis methods in rehabilitation.Journal of neuroengineering and rehabilitation[electronic resource],2006,3:4
30.孙嘉利,唐丹,钟世镇.三维步态分析的研究与应用[J].中国组织工程研究与临床康复,2007,11(5):944-948
31.Nollet F,Beelen A,Sargeant AJ,et al.Submaximal exercise capacity and maximal power output in polio subjects.Arch Phys Med Rehabil,2001,82(12):1678-85
32.Mukherjee G;Samanta A.Physiological response to the ambulatory performance of hand-rim and arm-crank propulsion systems..Rehabil Res Dev,2001,38(4):391-9
2.Gammaitoni L,Hanggi P,Jung P,et al.Stochastic resonance[J].Rev Modern Phys;1998,709(1):223-287
3.励建安,孟殿怀.步态分析的临床应用.中华物理医学与康复杂志,2006,28(7):500-503
4.陈勇.温情音乐与运动同步共振疗法最适合过劳人群[J],中国组织工程研究与临床康复,2007,11(52):10632-35
5.Utter AC,Robertson RJ,Validation of the Adult OMNI Scale of Perceived Exertion for Walking/Running Exercise.[J]Med.SCI.Sports Exerc,2004,36(10):1776-1780
6.Bereket S.Effects of Anthropometric parameters and stride frequency on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005,45(2):152-16
7.Shumway CA,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams & Wilkins,1995:308-314
8.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients:efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis.Arch Phys Med Rehabil,1996,77(11):1144-51
9.Dully CM,Hill AE,Graham HK.The influence of flexed-knee gait on the energy cost of walking in children.Developmental medicine and child neurology,1997,39(4):234-8
10.Waters R,Mulroy S.The energy expenditure of normal and pathologic gait.Gait Posture,1999,9:207-231
11.Kerrigan,DC.Guest editorial:aesthetics of walking.Journal Rehabilitation Research and Development,2001,38:ⅸ-ⅹ
12.Laughlin JE,King GA et al.Validation of the COSMED K4 b2portable metabolic system International journal of sports medicine,2001,22(4):280-284
13.Dffield R,Dawson B et al.Accuracy and reliability of a Cosmed K4b2 portable gas analysis system.J Sci Med Sport,2004,7(1):1
14.孙嘉利,唐丹,钟世镇.三维步态分析的研究与应用[J].中国组织工程研究与临床康复,2007,11(5):944-948
15.Nollet F,Beelen A,Sargeant AJ,et al.Submaximal exercise capacity and maximal power output in polio subjects.Arch Phys Med Rehabil,2001,82(12):1678-85
16.Mukherjee G,Samanta A.Physiological response to the ambulatory performance of hand-rim and arm-crank propulsion systems.Rehabil Res Dev,2001,38(4):391-9
17.石宗义,等.脊髓灰质炎后综合症流行病学调查.山东医药,1996,36(5):32
18.Nollet F,Beelen A.Submaximal exercise capacity and maximal power output in polio subjects[J].Arch Phys Med Rehabil,2001,82(12):1678-1685
19.许光旭,卢青.步态分析在偏瘫康复评定与治疗中的作用,中国运动医学杂志,1997,16(1):29-35
20.王桂茂.中风偏瘫步态的生物力学及其运动学特征分析.中国组织工程研究与临床康复,2007,40:8169-8172
21.Dalakas MC.How to design a therapeutic study in patients with the post-polio syndrome.Methodological concerns and status of present therapies.Ann N Y Acad Sci,1995;25(753):314-20.
22.励建安.神经疾病的步态分析[J].中国康复医学杂志,2005,20(4):304-306
23. Rimmer JH, Wang E. Aerobic exercise training in stroke survivors [J]. Top Stroke Rehabil, 2005, 12(1):17-30
24. Baker R. Gait analysis methods in rehabilitation. Journal of neuroengineering and rehabilitation, 2006, 3:4
25. Waters R, Mulroy S. The energy expenditure of normal and pathologic gait [J]. Gait Posture ,1999,9:207-231
1.励建安,孟殿怀,步态分析的临床应用.中华物理医学与康复杂志,2006,28(7):500-503
2.Eva Mattsson,Energy cost of level walking[J],Scandinavian Journal of Rehabilitation Medicine,Supplement No.23,1989
3.Bereket S.Effects of Anthropometric parameters and stride frequence on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005;45(2):152-16.
4.Bowen TR,Cooley SR et al.A method for normalization of oxygen cost and consumption in normal children while walking[J].J Pediatr Orthop,1998;18(5):589-593
5.Laughlin JE,King GA et al.Validation of the COSMED K4 b2portable metabolic system International journal of sports medicine,2001;22(4):280-284.
6.Dffield R,Dawson B et al.Accuracy and reliability of a Cosmed K4b2 portable gas analysis system.J Sci Med Sport,2004;7(1):1.
1.吴莉莉,惠国华,潘敏等.生物医学领域中随机共振的理论及应用研究[J],国际生物医学工程杂志,2007,30(2):86-90
2.Hiilloskorpi HK,Pasanen ME,MG Fogellholm.Use of heart rate to predict energy expenditure from low to high activity levels[J].Int J Sports Med,2003,24(5):332-336
3.Utter,AC,Robertson RJ,Validation of the Adult OMNI Scale of Perceived Exertion for Walking/Running Exercise.[J]Med.SCI.Sports Exerc,2004,36(10):1776-1780
4.Bereket S.Effects of Anthropometric parameters and stride frequence on estimation of energy cost of walking[J].J Sports Med Phys Fitness,2005,45(2):152-16
5.Shumway CA,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams & Wilkins,1995:308-314
6.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients: efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis. Arch Phys Med Rehabil, 1996,77(11):1144-51
7. Duffy CM, Hill AE, Graham HK. The influence of flexed-knee gait on the energy cost of walking in children. Developmental medicine and child neurology, 1997,39(4):234-8
8. Waters R, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture ,1999,9:207-231
9. Kerrigan, DC. Guest editorial: aesthetics of walking. Journal Rehabilitation Research and Development,2001,38:ix-x
10． 励建安．神经疾病的步态分析[J]．中国康复医学杂志,2005, 20(4)： 304—306
11. Laughlin JE, King GA et al. Validation of the COSMED K4 b2 portable metabolic system International journal of sports medicine, 2001,22 (4): 280-284
12. Dffield R, Dawson B et al. Accuracy and reliability of a Cosmed K4b2 portable gas analysis system. J Sci Med Sport, 2004,7(1):1
13. Karim Fouad, Keir Pearson. Progress in Neurobiology, 2004,73:107-126
14. Mulder DW, Rosenbaum RA, Layton DD Jr. Late progression of poliomyelitis or forme fruste amyotrophic lateral sclerosis? Mayo ClinProc,1972,47:756-61
15. Agre JC.The role of exercise in the patient with post-polio syndrome. Ann N Y Acad Sci, 1995 May 25,753:321-34
16. Brehm MA, Nollet F, Harlaar J.Energy demands of walking in persons with postpoliomyelitis syndrome: relationship with muscle strength and reproducibility. Arch Phys Med Rehabil, 2006,87(1):136-40
17.Willen C,Stibrant Sunnerhagen K,Ekman C,Grimby G.How is walking speed related to muscle strength? A study of healthy persons and persons with late effects of polio.Arch Phys Med Rehabil,2004,85(12):1923-8
18.许光旭,卢青.步态分析在偏瘫康复评定与治疗中的作用,中国运动医学杂志,1997;16(1):29-35
19.王桂茂.中风偏瘫步态的生物力学及其运动学特征分析,中国组织工程研究与临床康复,2007;40:8169-8172
20.Suzanne Kuys,Sandra Brauer,Louise Ada,Routine physiotherapy does not induce a cardiorespiratory training effect poststroke,regardless of walking ability[J].Physiother.Res.Int,2006;11(4):219-227
21.MacKay-Lyons MJ,Makrides L.Cardiovascular stress during a contemporary stroke rehabilitation program:is the intensity adequate to induce a training effect[J]? Arch Phys Med Rehabil,2002,83:1378-83
22.许光旭.偏瘫不对称步态的生物力学研究,中国康复医学杂志,1995;10(3):97-101
23.Robinson RG et al.Two-year longitudinal study of poststroke mood disorders:Diagnosis and outcome at one and outcome at one and two years.Stroke,1987;18:837-843
1.Moss CL,Wright PT.Comparison of Three Methods of Assessing Muscle Strength and Imbalance Ratios of the Knee.J Athl Train,1993,28(1):55-58
2.励建安,王彤.康复医学.北京:科学出版社,第一版,2002:52-258.
3.Shumway CA,Woolacott M.Motor Control:Theory and practical applications[M].Baltimore:Williams & Wilkins,1995:308-314
4.Beckerman H,Becher J,Lankhorst GJ,et al.Walking ability of stroke patients:efficacy of tibial nerve blocking and a polypropylene ankle-foot orthosis.Archives of physical medicine and rehabilitation,1996,77(11):1144-51
5.Duffy CM,Hill AE,Graham HK.The influence of flexed-knee gait on the energy cost of walking in children.Developmental medicine and child neurology,1997,39(4):234-8
6.Waters R,Mulroy S.The energy expenditure of normal and pathologic gait.Gait Posture.1999;9:207-231
7.Kerrigan,D.C.Guest editorial:aesthetics of walking.Journal Rehabilitation Research and Development.2001;38:ⅸ-ⅹ
8.丸山仁司.临床运动学.北京:中国中医药出版社,第三版,2002:190
9.Pretide AM.The double-labelled water method for measuring energy expenditure:technical recommendations for use in human,a consensus report by the international dietary energy consultancy working group[J].International Atomic Energy Agency Vienna,1990
10.Hilsan Taber S,Rimm EB,Stamper MJ,et al.Reproducibility and validity of a selfadministered physical activity questionnaire for male health professionals[J].Epidemiology,1996,7:81-86
11.高怀民.使用助行器械和矫形器步行训练的评估问题.现代康复,2000,4(7):966-967
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