Article

OBJECTIVE: To identify which frontal plane lower limb sensorimotor functions
predict gait speed and efficiency (step-width-to-step-length ratio) on an uneven
surface. DESIGN: Cross-sectional observational study. SETTING: A biomechanics
research laboratory. PARTICIPANTS: Thirty-three subjects (14 women [42.4%]; 21
with diabetic distal symmetric peripheral neuropathy [63.6%]), with a spectrum of
lower limb sensorimotor functions that ranged from normal to marked diabetic
neuropathy. METHODS: Independent variables included ankle inversion-eversion
proprioceptive thresholds, and normalized measures of maximum voluntary strength
and maximum rate of torque development (RTD) of hip abduction-adduction and ankle
inversion-eversion. Kinematic data were obtained by using an optoelectronic
system as subjects walked over an uneven 10-m surface. MAIN OUTCOME MEASURES:
Dependent variables included gait speed and efficiency (determined by
step-width-to-step-length ratio) on an uneven surface. RESULTS: Hip adduction RTD
and ankle inversion RTD predicted 54% of gait speed, with the former predicting
the majority (44%). Ankle inversion RTD was the only significant predictor of
gait efficiency, which accounted for 46% of its variability. Age did not predict
gait speed or efficiency. CONCLUSIONS: The rapid generation of strength in the
frontal plane at the hip and ankle is responsible for the successful negotiation
of irregular surfaces in older persons. Age demonstrated no independent
influence. Training regimens in older persons should include maneuvers that
rapidly develop strength in hip adductors and ankle invertors if navigation of
uneven surfaces is a functional goal.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS