中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (22): 3486-3491.doi: 10.12307/2023.391

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

行走步长影响老年人下肢肌力的仿真分析

宋翠荣1，陈童真2，刘美晓1，张海峰1   

  1. 1沧州医学高等专科学校基础教研室，河北省沧州市   061000；2沧州市人民医院康复科，河北省沧州市   061000
  • 收稿日期:2022-05-26 接受日期:2022-07-14 出版日期:2023-08-08 发布日期:2022-11-02
  • 通讯作者: 张海峰，硕士，副教授，医师，硕士生导师，沧州医学高等专科学校基础教研室，河北省沧州市 061000
  • 作者简介:宋翠荣，女，1977年生，河北省盐山县人，2007年天津医科大学毕业，硕士，副主任医师，主要从事老年医学研究。 陈童真，女，1981年生，河北省东光县人，2009年中南大学毕业，主要从事康复护理研究。
  • 基金资助:
    河北省卫健委资助项目(20210150)，项目负责人：张海峰

Simulated analysis of influence of walking step length on lower limb muscle strength in the elderly

Song Cuirong1, Chen Tongzhen2, Liu Meixiao1, Zhang Haifeng1   

  1. 1Basic Teaching and Research Office, Cangzhou Medical College, Cangzhou 061000, Hebei Province, China; 2Department of Rehabilitation, Cangzhou People’s Hospital, Cangzhou 061000, Hebei Province, China
  • Received:2022-05-26 Accepted:2022-07-14 Online:2023-08-08 Published:2022-11-02
  • Contact: Zhang Haifeng, Master, Associate professor, Physician, Master’s supervisor, Basic Teaching and Research Office, Cangzhou Medical College, Cangzhou 061000, Hebei Province, China
  • About author:Song Cuirong, Master, Associate chief physician, Basic Teaching and Research Office, Cangzhou Medical College, Cangzhou 061000, Hebei Province, China Chen Tongzhen, Department of Rehabilitation, Cangzhou People’s Hospital, Cangzhou 061000, Hebei Province, China
  • Supported by:
    a grant from Hebei Provincial Health Commission, No. 20210150 (to ZHF)

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摘要：


文题释义：

步长：步行过程中，一侧足跟(或足尖)到迈步后对侧足跟(或足尖)的距离，成年平均50-80 cm；是行走速度与能力的一个重要指标。老年人体能下降，常选择“快步走”进行锻炼，较注重速度指标，忽略步长大小；研究表明：大步长行走，有助于提高下肢肌力，锻炼效果更好。
仿真分析：当前实验室设备不能直接检测人体运动过程中的肌力信息，由仿真软件Oensim 4.0根据受试者形态参数建立人体骨骼、肌肉系统，导入运动捕捉系统记录的运动轨迹，将运动过程仿真重现，获得运动过程中的运动学和动力学数据；结合足底测力台进行验证，方法可靠，结果客观，为相关步态分析与生物力学研究构建平台。

背景：目前人口老龄化日趋严重，老年人不耐受高强度锻炼，骨骼、肌肉退化，常由于跌倒导致伤残或死亡，如何提高老年人的下肢肌力成为当前的研究热点问题。
目的：分析行走步长对老年人(> 60岁)下肢肌力的影响，探索高效的行走方式，为日常锻炼提供指导。
方法：选择30名健康老年人为受试者，均为男性，年龄65-75岁，测量其形态参数，导入仿真软件Opensim 4.0，分别建立各受试者骨肌模型。应用Vicon 2.3三维动作捕捉系统，实时记录各受试者正常步长、大步长行走的运动轨迹；同时采用足底三维测力台记录步行中足底受到的地面反作用力；将各受试者运动数据导入Opensim 4.0软件建立运动模型，进行动力学仿真，结合足底测力台数据验证其有效性。模型经验证后仿真各受试者在不同步长行走过程中，髂肌、腰大肌、股直肌、臀大肌、臀中肌、股二头肌、半腱肌、大收肌的肌力变化；将各受试者2次不同步长行走肌力数据分别导入SPSS 20.0进行统计分析，行配对t检验。
结果与结论：①建立了各受试者骨骼肌肉模型及不同步长行走的运动模型，导出各受试者不同步长行走过程中下肢重要肌肉的时间-肌力变化曲线；②经统计学分析，不同步长行走肌力差异有显著性意义(P > 0.05)；③步长与肌力变化的规律：正常步频下，增大步长幅度，股直肌、股二头肌、半腱肌肌力显著增加，髂肌、腰大肌、臀大肌、臀中肌、大收肌轻度增加；④提示增大步长行走可以提高下肢肌力，为老年人选择正确行走方式、相关康复训练以及运动处方开发提供理论基础。

https://orcid.org/0000-0003-0035-1743 (宋翠荣) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 行走步长, 肌力, 运动捕捉, 仿真, 日常锻炼

Abstract: BACKGROUND: Aging is becoming increasingly serious. The elderly with skeletal muscle degeneration do not tolerate high intensity exercise, and are easy to fall, resulting in disability or death. How to improve the lower limb muscle strength of the elderly has become a hot research issue.
OBJECTIVE: To provide guidance for daily activities through analyzing the influence of walking step length on lower limb muscle strength of the elderly (> 60 years old), and exploring the appropriate walking style. 
METHODS: Thirty healthy male elderly subjects aged 65-75 years old were randomly selected and their morphological parameters were measured. The skeletal muscle model was established by importing the simulation software Opensim 4.0. Vicon 2.3 three-dimensional motion capture system was used to record the movement track of the subjects’ normal step and large step walking in real time, and the plantar three-dimensional force platform was used to record the ground reaction force on the plantar during walking. The motion data of the subjects were imported into Opensim 4.0 software to establish the movement model, and the dynamic simulation was carried out. The effectiveness of the method was verified by the data of plantar dynamometer. Muscle strength changes of ilium, rectus femoris, psoas major, gluteus maximus, gluteus medius, biceps femoris, adductor magnus and medial femoral muscle were analyzed during walking with different step lengths in the elderly. The muscle strength data of two different pace walks of each subject were imported into SPSS 20.0 for statistical analysis, and paired t-test was performed.  
RESULTS AND CONCLUSION: (1) By establishing the skeletal muscle model of the subjects and the movement model of walking with different steps, the muscle strength curves of the important muscles of the lower limbs in the process of walking with different steps were derived. (2) Through statistical analysis, there were significant differences in the muscle strength of walking with different paces (P > 0.05). (3) The change rules of step length and lower limb muscle strength were summarized: within a certain range, with the increase of step length, the muscle strength of rectus femoris, medial femoris and semitendinosus increased significantly, while the muscle strength of ilium, psoas maximus, gluteus maximus, gluteus medius and adductor magnus increased slightly. (4) It is shown that walking with increased step length can improve lower limb muscle strength and can provide a theoretical basis for the elderly to choose correct walking style, rehabilitation training and exercise prescription development.  

Key words: step length, muscle strength, motion capture, simulation, daily exercise

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