[논문]Paralysis of the gastrocnemius medial head differentially affects gait patterns and muscle activity during level and stair ascent locomotion

Park, Dongho; Seong, Yeon-Jae; Woo, Hanseung; Yoo, Beomki; Shim, Dain; Kim, Eun Sang; Rha, Dong-wook

doi:10.1016/j.gaitpost.2019.06.019

Paralysis of the gastrocnemius medial head differentially affects gait patterns and muscle activity during level and stair ascent locomotion

Gait & posture, v.72, 2019년, pp.222 - 227

Park, Dongho (Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine) , Seong, Yeon-Jae (Hafis Clinic) , Woo, Hanseung (Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST)) , Yoo, Beomki (Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine) , Shim, Dain (Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine) , Kim, Eun Sang (Hafis Clinic) , Rha, Dong-wook (Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine)

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Abstract Background Prior studies have analyzed the activity of the gastrocnemius (GCM) medial and lateral heads as a single unit because it is technically challenging to separately analyze the function of each component in vivo. However, functional variation between the medial and lateral heads is expected due to their anatomical differences. Research question What is the independent function of the medial GCM? How does paralysis of the GCM medial head affect gait kinematics?. Methods Twelve healthy adults (two males and ten females; age: 28.2 [±7.72] years) that were scheduled to undergo neurolysis of the tibial nerve branch supplying the medial head of the GCM for aesthetic calf reduction participated in the study. Gait analysis was performed using a computerized opto-electric gait analysis system to measure kinematic data. Surface electromyography (EMG) was recorded simultaneously during the gait analysis. Surface electrodes were placed on seven muscles. Pre-procedure and 1-week and 3-month post-procedure data were compared using a linear mixed model. Results During level walking, decreased activity of the GCM medial head did not significantly change gait kinematics. However, a significant increase in GCM lateral head and hamstring activities occurred after a branch nerve block to the GCM medial head. During stair ascent, in contrast to level walking, changes in EMG activity only occurred in the GCM medial head, and post-procedure ankle dorsiflexion angles at the end of the terminal-stance phase significantly increased. Ankle plantarflexion angles during the push-off phase were also decreased when compared with pre-procedure values. Significance The human body response to dysfunction of the GCM medial head depended on the type of locomotion. Highlights Decreased medial GCM activity did not significantly change kinematics during gait. Lateral GCM activity significantly increased after nerve block during gait. There was a kinematic change during stair ascent. There was no compensatory hyperactivities in the lateral GCM during stair ascent.

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참고문헌 (24)

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Paralysis of the gastrocnemius medial head differentially affects gait patterns and muscle activity during level and stair ascent locomotion

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Paralysis of the gastrocnemius medial head differentially affects gait patterns and muscle activity during level and stair ascent locomotion

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