Muscle Activation and Movement Patterns During Prone Hip Extension Exercise in Women

Context:

The consistency of muscle activation order during prone hip extension has been debated.

Objective:

To investigate whether women use a consistent and distinguishable muscle activation order when extending the hip while prone and to explore the effects of verbal cues on muscle activation and movement.

Design:

Single-session, repeated-measures design.

Setting:

University laboratory.

Patients or Other Participants:

Eleven healthy women (age  =  27.7 ± 6.2 years [range, 22–37 years]).

Intervention(s):

We tested the participants under 3 conditions: no cues, cues to contract the gluteal muscles, and cues to contract the hamstrings muscles.

Main Outcome Measure(s):

We measured hip and knee angle and electromyographic data from the gluteus maximus, medial hamstrings, and lateral hamstrings while participants performed prone hip extension from 30° of hip flexion to neutral.

Results:

When not given cues, participants used the consistent and distinguishable muscle activation order of medial hamstrings, followed by lateral hamstrings, then gluteus maximus (195.5 ± 74.9, 100.2 ± 70.3, and 11.5 ± 81.9 milliseconds preceding start of movement, respectively). Compared with the no-cues condition, the gluteal-cues condition resulted in nearly simultaneous onset of medial hamstrings, lateral hamstrings, and gluteus maximus (131.3 ± 84.0, 38.8 ± 96.9, and 45.1 ± 93.4 milliseconds, respectively) (P > .059); decreased activation of the medial hamstrings (P < .03) and lateral hamstrings (P < .024) around the initiation of movement; increased activation of gluteus maximus throughout the movement (P < .001); and decreased knee flexion (P  =  .002). Compared with the no-cues condition, the hamstrings-cues condition resulted in decreased activation of the medial hamstrings just after the initiation of movement (P  =  .028) and throughout the movement (P  =  .034) and resulted in decreased knee flexion (P  =  .003).

Conclusions:

Our results support the contention that the muscle activation order during prone hip extension is consistent in healthy women and demonstrates that muscle timing and activation amplitude and movement can be modified with verbal cues. This information is important for clinicians using prone hip extension as either an evaluation tool or a rehabilitation exercise.     

四点跪位和手足位训练中躯干肌肉激活和共收缩模式比较

目的 分析四点跪位和手足位训练在躯干肌肉活动和共收缩模式上的异同,探究手足位训练作为核心稳定性训练的可能性,并为实际训练提供建议。方法 19名健康受试者参与研究,随机执行四点跪位（4个）和手足位（3个）动作,同时测量两侧腹直肌、腹外斜肌、竖脊肌、多裂肌的表面肌电信号。分析并比较基于表面肌电信号,得到肌电平均振幅值和肌肉共收缩指数。结果 四点跪位和手足位训练的组内和组间比较中,单一肌肉激活程度和共收缩指数都表现出统计学差异。四点跪位右手左腿抬起时,所有肌肉激活程度都高于起始位。四点跪位左腿抬起时同侧多裂肌明显高于手足位。手足位右手抬时腹外斜肌和腹直肌激活度较高。对8条肌肉两两匹配对共得到28种肌肉配对方式,四点跪位起始姿势波动最小,说明脊椎最为稳定,而其他动作指数波动范围较大。结论 从肌肉激活程度和共收缩两方面,证明了手足位训练作为核心稳定性训练的可能性。手足位训练和四点跪位训练可分别用于腹部肌肉和背部肌肉锻炼,而对侧上下肢抬起时,腹肌和背肌都能得到很好的锻炼,但需注意避免运动损伤。     

亚洲蹲和西方蹲的下肢关节运动学和肌肉激活比较

目的分析比较亚洲蹲和西方蹲动作中下肢关节运动学和肌肉激活程度的差异。方法以11名健康成年人为研究对象,采用三维运动捕捉系统、测力台和表面肌电同步采集两种下蹲动作的运动学、动力学和肌肉激活信息,并通过OpenSim计算下肢肌力。结果在膝关节弯曲角度峰值时刻,亚洲蹲骨盆前倾,而西方蹲骨盆后倾;此外,与亚洲蹲相比,西方蹲具有显著较小的髋关节屈角、较大的膝关节屈角、较大的髋关节外展角和内旋角。在自重深蹲的下降期和上升期中,西方蹲的比目鱼肌力峰值均显著大于亚洲蹲,西方蹲的胫骨前肌力均显著小于亚洲蹲,峰值时刻未见统计学差异。结论在亚洲蹲中,胫骨前肌激活和近侧端关节前屈可能有利于稳定;而在脚跟抬起的西方蹲中,比目鱼肌激活显著,但两者近端肌肉激活模式相同。研究结果为临床深蹲康复方案制定或深蹲训练方式的选择提供理论指导。     

Classifying Lower Extremity Muscle Fatigue During Walking Using Machine Learning and Inertial Sensors

Fatigue in lower extremity musculature is associated with decline in postural stability, motor performance and alters normal walking patterns in human subjects. Automated recognition of lower extremity muscle fatigue condition may be advantageous in early detection of fall and injury risks. Supervised machine learning methods such as support vector machines (SVMs) have been previously used for classifying healthy and pathological gait patterns and also for separating old and young gait patterns. In this study we explore the classification potential of SVM in recognition of gait patterns utilizing an inertial measurement unit associated with lower extremity muscular fatigue. Both kinematic and kinetic gait patterns of 17 participants (29 ± 11 years) were recorded and analyzed in normal and fatigued state of walking. Lower extremities were fatigued by performance of a squatting exercise until the participants reached 60% of their baseline maximal voluntary exertion level. Feature selection methods were used to classify fatigue and no-fatigue conditions based on temporal and frequency information of the signals. Additionally, influences of three different kernel schemes (i.e., linear, polynomial, and radial basis function) were investigated for SVM classification. The results indicated that lower extremity muscle fatigue condition influenced gait and loading responses. In terms of the SVM classification results, an accuracy of 96% was reached in distinguishing the two gait patterns (fatigue and no-fatigue) within the same subject using the kinematic, time and frequency domain features. It is also found that linear kernel and RBF kernel were equally good to identify intra-individual fatigue characteristics. These results suggest that intra-subject fatigue classification using gait patterns from an inertial sensor holds considerable potential in identifying “at-risk” gait due to muscle fatigue.     

Trunk and Lower Extremity Kinematics During Stair Descent in Women With or Without Patellofemoral Pain

Context

There is limited evidence indicating the contribution of trunk kinematics to patellofemoral pain (PFP). A better understanding of the interaction between trunk and lower extremity kinematics in this population may provide new avenues for interventions to treat PFP.

Objective

To compare trunk and lower extremity kinematics between participants with PFP and healthy controls during a stair-descent task.

Design

Cross-sectional study.

Setting

Research laboratory.

Patients or Other Participants

Twenty women with PFP (age = 22.2 ± 3.1 years, height = 164.5 ± 9.2 cm, mass = 63.5 ± 13.6 kg) and 20 healthy women (age = 21.0 ± 2.6 years, height = 164.5 ± 7.1 cm, mass = 63.8 ± 12.7 kg).

Intervention(s)

Kinematics were recorded as participants performed stair descent at a controlled velocity.

Main Outcome Measure(s)

Three-dimensional joint displacement of the trunk, hip, and knee during the stance phase of stair descent for the affected leg was measured using a 7-camera infrared optical motion-capture system. Pretest and posttest pain were assessed using a visual analogue scale. Kinematic differences between groups were determined using independent-samples t tests. A 2 × 2 mixed-model analysis of variance (group = PFP, control; time = pretest, posttest) was used to compare knee pain.

Results

We observed greater knee internal-rotation displacement for the PFP group (12.8° ± 7.2°) as compared with the control group (8.9° ± 4.4°). No other between-groups differences were observed for the trunk, hip, or other knee variables.

Conclusions

We observed no difference in trunk kinematics between groups but did note differences in knee internal-rotation displacement. These findings contribute to the current knowledge of altered movement in those with PFP and provide direction for exercise interventions.Key Words: anterior knee pain, knee internal rotation, neuromuscular control

Key Points

• Trunk kinematics did not differ between women with and without patellofemoral pain during stair descent.
• Women with patellofemoral pain demonstrated greater knee internal-rotation displacement during stair descent than women without patellofemoral pain.

Patellofemoral pain (PFP) is one of the most frequent chronic injuries among females.^1,2 The causes of PFP are multifactorial, with patellofemoral malalignment commonly accepted as a major contributor.^2,3 Patellofemoral malalignment increases contact pressure within the patellofemoral joint, leading to abnormal cartilage wear and ultimately degenerative changes if left untreated or if conservative treatment options fail.^4,5Lower extremity kinematics may directly influence patellofemoral contact pressure during dynamic tasks. Specifically, the motions of femoral internal rotation, femoral adduction, and knee valgus increase patellofemoral contact pressure.^3,6–8 Extensive research^3,6,9–13 has been conducted to determine alterations in lower extremity kinematics associated with PFP. Lower extremity kinematics may be influenced by other factors that, if recognized, may have a significant effect on treatment interventions for those with PFP.Although there is evidence that trunk kinematics influence lower extremity kinematics and loading,^14–16 few studies have examined trunk kinematics in participants with PFP.^17,18 The presence of aberrant trunk motion in those with PFP and its influence on lower extremity kinematics has been theorized.¹⁹ In the frontal plane specifically, it has been proposed that individuals with PFP who display hip-abductor weakness compensate by elevating the contralateral pelvis and leaning toward the stance limb. This trunk lean has the potential to alter the orientation of the ground reaction force and subsequent external moments acting on the knee in the frontal plane. In the sagittal plane, trunk flexion moves the ground reaction force vectors anteriorly to both the hip and knee joints, thereby increasing the demand of the hip extensors and decreasing the demand of the knee extensors. Decreasing the quadriceps demand decreases the compressive forces within the patellofemoral joint.¹⁹ Given that previous researchers^13,14,16 have demonstrated a relationship between trunk and lower extremity kinematics in a healthy population, it is plausible that individuals with PFP may have altered trunk kinematics that indirectly influence patellofemoral contact pressure.The primary purpose of our study was to compare trunk and lower extremity kinematics during stair descent between women with and without PFP. Our a priori hypotheses were that women with PFP would have greater trunk rotation and lateral flexion toward the stance leg and greater overall trunk flexion. Based on previously reported observations,^20–25 we also expected to observe greater hip adduction, hip internal rotation, and knee valgus in those with PFP.     

Effects of Developmental Stage and Sex on Lower Extremity Kinematics and Vertical Ground Reaction Forces During Landing

Context: The presence or absence of biomechanical differences between the sexes before puberty may provide clues about the onset of adult landing pattern differences, which may help to explain the greater number of anterior cruciate ligament injuries in females than in males and provide the basis for interventions to reduce those injuries.Objective: To identify developmental sex-related and biomechanical differences during vertical jump landings.Design: A 2 x 2 developmental stage (prepubescent or postpubescent) x sex (male or female) between-subjects design.Setting: Controlled laboratory setting.Patients or Other Participants: Thirty prepubescent subjects (15 boys, age = 9.63 +/- 0.95 years; 15 girls, age = 9.19 +/- 1.00 years) and 28 postpubescent subjects (14 men, age = 23.57 +/- 3.23 years; 14 women, age = 24.22 +/- 2.27 years).Intervention: Subjects performed a vertical jump to a target set at 50% of their maximum vertical jump height ability.Main Outcome Measure(s): Hip and knee kinematics of the dominant lower extremity and vertical ground reaction forces during impact were analyzed.Results: We found significant main effects for developmental stage. Children demonstrated greater knee valgus and less hip flexion at initial contact and at maximum vertical force, less knee flexion at maximum vertical force, greater maximum vertical force and impulse, and a shorter time to maximum vertical force than the adults. No sex differences were found among the biomechanical variables measured.Conclusions: The presence of significant biomechanical differences between children and adults suggests that physical development influences landing patterns. Sex does not appear to influence landing patterns during a 50% maximum vertical jump landing. These findings add to the body of knowledge regarding developmental and sex comparisons in a functional landing task.     

Effects of Log-Rolling Position on Hip-Abductor Muscle Activation During Side-Lying Hip-Abduction Exercise in Participants With Gluteus Medius Weakness

ContextWeakness of the gluteus medius and gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergistic muscles that are not targeted should be considered when prescribing side-lying hip-abduction (SHA) exercises. Log-rolling positions may affect hip-abductor activity during SHA.ObjectiveTo determine the effects of log-rolling positions on gluteus medius, gluteus maximus, and tensor fasciae latae activity during SHA in participants with gluteus medius weakness.DesignControlled laboratory study.SettingUniversity research laboratory.Patients or Other ParticipantsTwenty-one participants with gluteus medius weakness.Intervention(s)Three types of SHA were performed: frontal-plane SHA in neutral position (SHA-neutral), frontal-plane SHA in anterior log-rolling position (SHA-anterior rolling), and frontal-plane SHA in posterior log-rolling position (SHA-posterior rolling).Main Outcome Measure(s)Surface electromyography was used to measure hip-abductor activity. One-way repeated-measures analysis of variance was calculated to assess the statistical significance of the muscle activity.ResultsThe SHA-anterior rolling showed greater gluteus medius and gluteus maximus activation than the SHA-neutral (P = .003 and P < .001, respectively) and SHA-posterior rolling (P < .001 and P < .001, respectively). The SHA-neutral demonstrated greater gluteus medius and gluteus maximus activation than the SHA-posterior rolling (P < .001 and P = .001, respectively). The SHA-anterior rolling produced less tensor fasciae latae activation than the SHA-neutral (P < .001) and SHA-posterior rolling (P < .001). The SHA-neutral showed less tensor fasciae latae activation than the SHA-posterior rolling (P < .001).ConclusionsThe SHA-anterior rolling may be an effective exercise for increasing activation of the gluteus medius and gluteus maximus while decreasing activation of the tensor fasciae latae in participants with gluteus medius weakness.     

Effects of Plyometric Training on Muscle-Activation Strategies and Performance in Female Athletes

OBJECTIVE: To evaluate the effects of plyometric training on muscle-activation strategies and performance of the lower extremity during jumping exercises. SUBJECTS: Twenty healthy National Collegiate Athletic Association Division I female athletes. DESIGN AND SETTING: A pretest and posttest control group design was used. Experimental subjects performed plyometric exercises 2 times per week for 6 weeks. MEASUREMENTS: We used surface electromyography to assess preparatory and reactive activity of the vastus medialis and vastus lateralis, medial and lateral hamstrings, and hip abductors and adductors. Vertical jump height and sprint speed were assessed with the VERTEC and infrared timing devices, respectively. RESULTS: Multivariate analyses of variance revealed significant (P <.05) increases in firing of adductor muscles during the preparatory phase, with significant interactions for area, mean, and peak. A Tukey honestly significant difference post hoc analysis revealed significant increases in preparatory adductor area, mean, and peak for experimental group. A significant (P =.037) increase in preparatory adductor-to-abductor muscle coactivation in the experimental group was identified, as well as a trend (P =.053) toward reactive quadriceps-to- hamstring muscle coactivation in the experimental group. Pearson correlation coefficients revealed significant between-groups adaptations in muscle activity patterns pretest to posttest. Although not significant, experimental and control subjects had average increases of 5.8% and 2.0% in vertical jump height, respectively. CONCLUSIONS: The increased preparatory adductor activity and abductor-to-adductor coactivation represent preprogrammed motor strategies learned during the plyometric training. These data strongly support the role of hip-musculature activation strategies for dynamic restraint and control of lower extremity alignment at ground contact. Plyometric exercises should be incorporated into the training regimens of female athletes and may reduce the risk of injury by enhancing functional joint stability in the lower extremity.     

产后女性进行盆底肌康复治疗对其性功能障碍的改善效果

目的:探究产后女性进行盆底肌康复治疗对其性功能障碍的改善效果。方法:随机选取我院收治的120例产后女性患者,按照数字表法分组,将其分为试验组、对照组两组,对照组采用常规康复治疗,试验组开展盆底肌康复训练治疗,对比分析两组患者预后情况。结果:试验组女性患者治疗后3个月、6个月的性交频率与对照组患者相比明显较高,差异有统计学意义(t=-17.0692,-20.9648;P0.05)。试验组女性患者治疗后3个月、6个月的性功能评分与对照组患者相比明显较高,差异有统计学意义(t=-18.1220,-10.8083;P0.05)。结论:产后女性进行盆底肌康复治疗后,有利于提高性功能,增加性交频率,预后效果显著,临床意义重大。     

Abdominal Muscle Activity While Performing Trunk-Flexion Exercises Using the Ab Roller, ABslide, FitBall, and Conventionally Performed Trunk Curls

OBJECTIVE: To compare the surface electromyographic activity of the abdominal musculature and rectus femoris (RF) muscle during trunk-flexion exercises using 3 abdominal exercise devices (Ab Roller, ABslide, and FitBall) and the traditional trunk curl. DESIGN AND SETTING: Each subject performed approximately 15 repetitions for each exercise condition. A repeated-measures, one-way multivariate analysis of variance was used to compare the mean integrated electric activity value for each muscle during each exercise condition. SUBJECTS: A total of 10 male and 13 female collegiate undergraduate students. MEASUREMENTS: Surface electromyographic activity was recorded for the upper rectus abdominis (URA), lower rectus abdominis (LRA), external oblique (EO), and RF during 5 consecutive repetitions of each exercise bout. The signal was amplified by a factor of 1000, rectified, and integrated. These integrated values were then divided by the time value for each exercise to give the mean integrated electromyography value. RESULTS: A significant difference existed among exercise conditions for the RF (P <.0001), with the ABslide and the FitBall having greater electric activity than the other exercise conditions. Activity was significantly different (P <.0009) for the URA, with the ABslide having the least electric activity. For the EO, exercising with the ABslide produced significantly greater electric activity (P <.0001) than all other exercise conditions. No significant difference was found across exercise conditions for the LRA (P <.051). CONCLUSIONS: Performing abdominal exercises with the Ab Roller, ABslide, and FitBall did not elicit greater activity of the URA and LRA than performing traditional trunk curls. Use of the ABslide elicited greater EO activity and significantly less URA activity than the other 3 modes. Both the ABslide and FitBall resulted in greater involvement of the hip flexors, an undesirable feature of abdominal exercises.     

太极拳转体动作中下肢关节活动顺序性和肌肉力表现及肌肉激活特征

目的 分析太极拳转体与弓步动作中下肢关节活动顺序性、肌肉力表现和肌肉激活程度的差异,揭示太极拳转体动作的特征。 方法 募集 20 名练习时长超过 3 年的健康太极拳练习者,采用三维运动捕捉系统、测力台和表面肌电同步采集转体与弓步两种动作运动学、动力学和肌肉激活信息,并通过 OpenSim 仿真软件获取下肢肌力。结果 与弓步相比,转体动作髋、踝关节外旋幅度显著增大;膝关节外展和外旋力矩显著增大,股二头肌、半腱肌和内外侧腓肠肌峰值肌力显著增强,股二头肌、内外侧腓肠肌峰值肌力时刻显著提前,而股内外侧肌和胫骨前肌峰值肌力显著减小,胫骨前肌肌力最早达到峰值;股二头肌、股内外侧肌和内侧腓肠肌的平均激活水平和激活时间显著增加。 结论 太极拳转体动作由踝、髋关节依次转动组成,肌肉力表现的独特性在于重心两次转移致使支撑腿内外侧肌力曲线呈双峰型,因为全足着地延迟方式引发了腓肠肌与股四头肌激活顺序和肌肉平均激活水平改变。研究结果提示全足着地延迟方式具有调节肌肉激活顺序的作用,合理利用有助于提升临床康复效果。     

不同地面对跑步下肢运动生物力学的影响

诸多因素会影响跑步运动损伤的发生,其中内在因素包括人体解剖学因素、受伤史、下肢运动生物力学和运动中的神经肌肉控制等,外在因素包括训练方法、跑步鞋、跑步路面等。跑步路面被认为是造成跑步运动损伤发生的重要潜在风险因素之一。总结不同地面对跑步下肢运动学、动力学、神经肌肉调控、运动损伤方面的影响,发现在不同地面跑步时,人体可能通过自身的神经肌肉调节功能进行运动学调整以获得动力学适应,调节下肢刚度以获得相似的冲击负荷。但是目前关于在不同路面上跑步的生物力学变化,多数研究只关注于运动学、动力学和神经肌肉调控中的某一方面,缺乏更进一步具体的三维运动生物力学数据,以及针对这种生物力学调整的具体神经肌肉调控机制。     

下肢康复训练减重支撑系统的研究现状

目的：下肢减重康复训练已成为下肢功能康复重要的治疗方法之一,因其在恢复步行能力、纠正步态、改善平衡、减轻肌肉痉挛、减少心肺负荷等方面具有优势,故下肢减重康复训练越来越受到众多学者的关注。然而,下肢康复训练减重支撑系统是下肢减重康复训练必不可少的一部分,因为合理舒适的减重支撑系统对于减重康复训练的效果具有较大的影响。因此随着科技的发展下肢康复训练减重支撑系统也在一步步改进以满足患者的需求。本文对下肢康复训练减重支撑系统的国内外研究现状进行综述,并展望其发展趋势。方法：通过查阅国内外相关文献,同时融合本单位的相关经验分析总结进行综述。结果：目前所使用的减重支撑系统（BWS）主要有悬吊减重系统、斜床背部支撑减重系统、水浮力减重系统、空气压差式减重系统等。结论：上述几种减重系统都有其缺点,在使用时具有一定的局限性,因此需要进行相关技术的进一步改进以设计出更加自然、合理的下肢减重支撑系统以满足更多患者的需求,故下肢康复训练减重支撑系统具有广阔的发展空间和良好的应用前景。     

系统化康复护理在老年髋部骨折患者围手术期中的应用

目的 研究系统化康复护理对老年髋部骨折手术患者的影响。方法 选取2016年7月~2018年6月我院收治的老年髋部骨折患者125例,随机分为观察组（63例）和对照组（62例）。对照组给予常规护理,观察组在常规护理基础上给予系统化康复护理,比较两组护理前、术后1个月、术后3个月Harris髋关节功能评分和Barthel 指数评分,住院费用、住院时间及术后并发症发生率。结果 两组护理后Harris髋关节功能评分、Barthel 指数评分、住院时间及住院费用、术后并发症发生率比较,差异均有统计学意义（P＜0.05）。结论 系统化康复护理能有效改善老年髋部骨折手术患者的关节活动功能,缩短住院时间,减少住院费用,提高生活质量及生活自理能力。     

人工髋关节置换术后并发有症状下肢深静脉血栓临床分析

目的：探讨有症状下肢深静脉血栓（DVT）的发生率、临床特点及药物预防DVT的可行性。方法：2006年1月～2009年12月行人工髋关节置换术232例,术后连续腹壁脐周皮下注射低分子肝素钙4000U／d×10d,口服阿司匹林1片／d×30d。其中13例分别于术后第3～9天先后出现术侧下肢循环障碍临床表现,结合下肢深静脉彩超或下肢深静脉造影检查,均确诊为有症状下肢DVT,并立即行取栓术治疗。结果：13例患者行取栓术后,临床症状消失,Homans征和Neuhof征转为阴性。2例患者术后伤口渗出增加,细菌培养阴性,停用低分子肝素钙后伤口渗出减少,至术后2周伤口完全愈合。出院后随访1．5个月,再次行下肢深静脉彩超或下肢深静脉造影,未发现有血栓形成。结论：术前和术后患肢发生不明原因的肿痛时,应警惕下肢DVT的存在。早期诊断DVT,早期手术,并规范应用抗凝剂,联合早期功能锻炼,可以有效的防治下肢DVT。     

Comparison of the Safety and Effectiveness of Lower Extremity Artery Bypass Grafting and Endovascular Angioplasty in the Treatment of Lower Extremity Arteriosclerosis Obliterans in the Elderly

Objective:To compare the safety and effectiveness of lower extremity artery bypass grafting and endovascular angioplasty in the treatment of lower extremity arteriosclerosis obliterans in the elderly.Methods:The data of 87 elderly patients with lower extremity arteriosclerosis obliterans treated in our hospital from August 2015 to August 2017 were analyzed retrospectively.According to the different treatment methods,they were divided into angioplasty group(n=45,intravascular angioplasty) and bypass grafting group(n=42,lower extremity artery bypass grafting).The success rate,hemodynamics of dorsalis pedis artery and nerve conduction of lower extremity were compared between the two groups Velocity,VAS score,late target vessel lumen loss(LLL),patency rate,restenosis rate,ankle brachial index(ABI) and clinical adverse events.Results:There was no significant difference between angioplasty group and bypass group(P0.05).One month after operation,the hemodynamics of dorsalis pedis artery and nerve conduction velocity of lower limbs in the two groups were better than those before operation,the difference was statistically significant(P0.05),but there was no significant difference between the two groups(P0.05).The VAS score of the two groups was significantly lower than that of the preoperative group(P0.05),but there was no significant difference between the two groups(P0.05).The ABI of the two groups was significantly improved after operation,the difference was statistically significant(P0.05),but there was no significant difference between the groups at each time point(P0.05).There was no significant difference in LLL,patency rate and restenosis rate between the two groups(P0.05).There was statistical difference in the incidence of complications between the two groups(P0.05).During the follow-up period,no serious adverse events such as death or amputation occurred in both groups.Conclusion:Endovascular angioplasty and lower extremity artery bypass grafting have the same clinical effect in the treatment of elderly patients with lower extremity arteriosclerosis obliterans,which are safe and feasible.