便携步态分析量化评价脊髓型颈椎病患者的步态特征

背景：步态改变是脊髓型颈椎病重要的诊断依据和手术指征；传统的三维步态实验室因操作复杂和耗时费力等原因，无法真正应用于临床前沿。近些年，基于微型传感器的便携式步态分析设备逐渐兴起和发展，部分经过了临床应用验证，使患者在病房里进行步态分析成为现实。目的：以便携式步态分析仪量化评估脊髓型颈椎病的步态特点。方法：选择2013年3至11月连续住院治疗的15例伴有步态异常的脊髓型颈椎病患者纳入患者组，同期30例健康受试者纳入对照组。受试者佩戴便携式步态分析仪在30 m的平地上来回自由行走120 m进行检测，共12个步态参数纳入研究，包括7个常用步态参数：单腿站立时间、双腿站立时间、步态周期时间、速度、步频、步长、跨步长及5个新定义的步态参数：拔腿强度、摆腿强度、地面反冲、足落地控制和摆动前期角度。3例患者接受常规颈椎减压，治疗后1周佩戴颈托下地后再次进行步态测试。结果与结论：与对照组相比，患者组患者的双腿站立时间和步态周期明显延长（P＜0.05），速度、步频、步长、跨步长、摆腿强度、地面反冲、足落地控制和摆动前期角度明显减小（P＜0.05），而单腿站立时间和拔腿强度差异无显著性意义（P＜0.05）。3例手术患者治疗后日本骨科学会评分改善率32.5%，摆腿强度在图形上可见明显改善。脊髓型颈椎病患者日本骨科学会评分与所有12项检测的步态参数均有不同程度的相关性。说明便携式步态分析仪能够有效检测测量伴有步态异常的脊髓型颈椎病患者的病理步态，可协助客观量化评估下肢神经功能的变化。

Evaluation of gait characteristics of cervical spondylotic myelopathy patients by a portable gait analyzer

BACKGROUND：Gait deviations are the important diagnosis criteria and surgical indications of cervical myelopathy. Conventional three-dimensional gait laboratory failed to apply in clinics due to complex operations and time consuming. In recent years, a portable gait analyzer based on the micro-sensors is emerging and developing, it has been verified by clinical practice, al owing gait analysis in the ward.OBJECTIVE：To quantitatively analyze gait characteristics of patients with cervical spondylotic myelopathy （CSM） by a portable gait analyzer.METHODS：From March 2013 to November 2013, 15 CSM patients and 30 healthy subjects were enrol ed in the study. The involved patients were accompanied by gait abnormalities. A portable gait analyzer was used for gait analysis. Subjects walked on a 30-meter corridor back and forth for 120 meters. Total y 12 gait parameters were＆amp;nbsp;involved in this study, including seven common parameters （single limb support, double limb support, gait cycle, speed, cadence, step length and stride length） and five new parameters （pul ing acceleration, swing power, ground impact, foot fal , and pre-swing angle）. Three patients underwent cervical decompression surgery. The gait characteristics were re-evaluated one week later, carrying neck support.RESULTS AND CONCLUSION：The double limb support and gait cycle duration of CSM group were significantly longer than control group （P〈0.05）. Speed, cadence, step length, stride length, swing power, ground impact, foot fal , and pre-swing angle of CSM patients were significantly smal er than healthy subjects （P〈0.05）. No differences were found in single limb support and pul ing acceleration （P〈0.05）. after cervical decompression surgery, the mean remission rate of Japanese Orthopedics Association scores was 32.5%and lower limb acceleration was improved obviously in the graph one week after surgery. Varying degree of correlation was seen between Japanese Orthopedics Association scores and the detected 12 gait parameters in CSM patients. The portable gait analyzer can effective measure the pathological gait deviation in CSM patients with abnormal gaits, and assists to evaluate the lower limb functions.