정상인에서 쭈그림보행 시뮬레이션 시 관찰된 보상적 전략

Compensatory Strategy Observed in the Simulated Crouch Gait of Healthy Adults

This simulation study investigated the characteristics of normal gait, 30° crouch gait, 30° crouch/equinus gait, 45° crouch gait, 45° crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporalparameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the 45° crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and 45° crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.