正常孕妇步行时骨盆及胸廓水平面旋转运动.docVIP

正常孕妇步行时骨盆及胸廓水平面旋转运动 　【摘要】 目的 研究妊娠对步行时骨盆和胸廓水平面上旋转运动的影响。 方法 研究孕妇和未孕妇女在步行机上不同速度行走时的步态运动。比较孕妇组(n=12)和对照组(n=13)的最舒适步行速度、骨盆和胸廓在水平方向上旋转运动的幅度及两者间运动协调性的差异。 结果 孕妇的最舒适步行速度呈显著性下降(Plt;0.05),骨盆和胸廓在水平面的旋转运动幅度略有减少(Pgt;0.05),但其各自的个体内标准差呈显著性减少(Plt;0.05)。孕妇在水平面上骨盆和胸廓的旋转运动的傅立叶相差略变小(Pgt;0.05),但傅立叶相差的个体内标准差与怀孕周数呈显著性负性相关,并且在速度≥1.06 m/s时显著性减少(Plt;0.05)。 结论 孕妇的步态运动与未孕妇女相似,前者完成快速行走时骨盆和胸廓的反相协调运动难度加大。 【关键词】 孕妇; 步行; 步态; 胸部; 骨盆; 生物力学 　　　ABSTRACT: Objective To investigate the effects of pregnancy on the coordination of transverse pelvic and thoracic rotations during gait. Methods Gait of healthy pregnant women and nulligravidae was studied during treadmill walking at predetermined velocities. Comfortable walking velocity, amplitudes of pelvic and thoracic rotations, and their coordination were compared between the two groups. Results Comfortable walking velocity was significantly reduced. The rotational amplitudes of pelvis and thorax were somewhat reduced, with significantly smaller intraindividual standard deviations. Also pelvisthorax Relative Fourier Phase was a little smaller; its intraindividual standard deviation was significantly reduced at velocities ≥ 1.06 m/s. Conclusion The general pattern of gait kinematics in pregnant women is very similar to that of nulligravidae. Pregnant women experienced difficulties in realizing the harder antiphase pelvisthorax coordination that was required at higher walking velocities. 　　KEY WORDS: pregnant women; walking; gait; pelvis; thorax; biomechanics　 长期以来,人们一直认为妊娠影响孕妇的步态运动。Foti等研究发现,孕妇步行时跖屈的动量减少,髋关节外展的动量及骨盆的倾斜度均增加,骨盆的倾斜度的改变存在较大的个体差异[1]。Nagy等报道孕妇最舒适的步行速度显著性降低,亦存在较大的个体差异[2]。但Foti等认为这种变化并无统计学意义,并发现怀孕对步长或步周期长无显著性影响[1]。上述研究显示,孕妇的步态发生改变,但研究结果并不一致。大约25%患有妊娠相关骨盆痛的孕妇和5%产后患者需要就诊治疗,重症患者常常出现步行障碍[3]。对正常孕妇运动协调的研究可作为今后研究妊娠相关骨盆痛的步态运动的基础。笔者研究怀孕对步行时水平面上骨盆和胸廓运动协调的影响,以期有助于从生物力学的角度进一步了解妊娠相关骨盆痛患者的步态运动。 　　1 对象与方法 　　1.1 对象 选取年龄20～45周岁的健康未孕妇女(对照组)和健康孕妇(孕妇组)作为观察对象。对照组13例,年龄中位数27岁(22～36岁),体质量中位数75 kg (45～95 kg),身高中位数172 cm(157～190 cm);孕妇组12例,年龄中位数32岁(30～38岁),体质量中位数76.