ABSTRACT
Background: Lower limb amputees exhibit postural control deficits during standing which can affect their walking ability. Objectives: The primary purpose of the present study was to analyze the thorax, pelvis, and hip kinematics and the hip internal moment in the frontal plane during gait in subjects with Unilateral Transtibial Amputation (UTA). Method: The participants included 25 people with UTA and 25 non-amputees as control subjects. Gait analysis was performed using the Vicon(r) Motion System. We analyzed the motion of the thorax, pelvis, and hip (kinematics) as well as the hip internal moment in the frontal plane. Results: The second peak of the hip abductor moment was significantly lower on the prosthetic side than on the sound side (p=.01) and the control side (right: p=.01; left: p=.01). During middle stance, the opposite side of the pelvis was higher on the prosthetic side compared to the control side (right: p=.01: left: p=.01). Conclusions: The joint internal moment at the hip in the frontal plane was lower on the prosthetic side than on the sound side or the control side. Thorax and pelvis kinematics were altered during the stance phase on the prosthetic side, presumably because there are mechanisms which affect postural control during walking. .
Subject(s)
Female , Humans , Male , Middle Aged , Amputation, Surgical , Gait , Hip/physiopathology , Pelvis/physiopathology , Thorax/physiopathology , Walking , Biomechanical Phenomena , LegABSTRACT
La enfermedad de Parkinson (EP) es un trastorno neurológico, discapacitante y progresivo caracterizado por múltiples síntomas motores y no motores que contribuyen al deterioro en la calidad de vida del paciente. La diversidad de síntomas asociados a la enfermedad y su manejo afectan a la funcionalidad y las expectativas del individuo sobre su bienestar físico, social y mental, que son los componentes fundamentales de la calidad de vida relacionada con la salud (CVRS). El objetivo del presente trabajo fue identificar las principales dimensiones de la CVRS afectadas en una población con EP con un grado de afectación leve-moderado. Treinta y seis pacientes con EP completaron este estudio transversal. Se emplearon el estadio de Hoehn y Yarh, el Unified Parkinson's Disease Rate Scale, la escala de actividades de la vida diaria de Schwab y England y el Test Get Up & Go. La calidad de vida fue valorada con el EuroQoL-5D y con el cuestionario Parkinson's Disease Questionnaire-39 items. Las dimensiones del PDQ-39, excepto el dominio PDQ-39 Dolor, así como el cuestionario EuroQoL-5D se correlacionaron de manera significativa con la gravedad de la enfermedad. La CVRS se correlacionó con el estado funcional de los pacientes. Únicamente el dominio PDQ-39 Dolor se correlacionó con el riesgo de caídas. Nuestros resultados sugieren que la CVRS de los pacientes con EP, en un estado leve-moderado de afectación, está muy influenciada por la gravedad de la enfermedad y el estado funcional.
Parkinson's disease is a disabling and progressive neurological condition characterized by multiple motor and non motor symptoms that contribute to deterioration in quality of life. The diversity of symptoms associated with the disease and its management affect the patients on their physical, social and mental quality of life. The aim of this study was to identify key dimensions of health related quality of life (HRQOL) in a population affected with Parkinson's disease with a degree of mild-moderate impairment. Thirty six patients with Parkinson were recruited. The Hoehn and Yarh scale, the Unified Parkinson's Disease Rate Scale, the scale of activities of daily life and Schwab & England Get Up & Go Test were applied. HRQOL was assessed with the EuroQol-5D and the specific questionnaire Parkinson's Disease Questionnaire-39 items. The dimensions of the PDQ-39, except the PDQ-39 Pain domain and the EuroQol-5D correlated significantly with the severity of the disease. HRQOL was correlated with the functional status of patients. Only the PDQ-39 pain domain correlated with the risk of falls. Our results suggest that the HRQOL of patients with PD, in a state of mild-moderate impairment, is strongly influenced by disease severity and functional status.