不同任务干扰对儿童早期步态特征和任务成本的影响

doi:10.3969/j.issn.1006-9771.2023.09.011

Abstract

Abstract:

Objective To investigate the influence of interference tasks and age on gait characteristics and task costs of children aged three to eight years.

Methods From April to August, 2021, 200 children from a kindergarten and primary school in Cangzhou, Hebei were enrolled to collect gait spatiotemporal parameters and kinematics data with infrared motion capture system; ground reaction force was collected with the Kistler force platform and simulated with Anybody 7.0, as walking naturally (standard gait), answering question (cognitive gait) and crossing obstacle (obstacle-crossing gait).

Results A total of 182 children finished the test. The main effect of task was significant on spatiotemporal parameters (F > 5.167, P < 0.01), as well as age (F > 2.321, P < 0.05), except on stride width and speed; while the interaction effect of task and age was significant on double stance phase, single stance phase and step length (F > 3.040, P < 0.01). The main effect of task was significant on kinematics data (F > 83.019, P < 0.001), as well as age (F > 2.359, P < 0.05), except on range of motion of knee and maximum angular velocity of ankle; while the interaction effect of task and age was significant (F > 2.066, P < 0.05), except on range of motion of hip. The main effect of task and age was significant on kinetic parameters (F > 4.032, P < 0.05); while the interaction effect of task and age was significant (F > 2.189, P < 0.05), except on the strength of medial soleus, lateral gastrocnemius, medial gastrocnemius and tibialis anterior. The coefficient of variation was the most for cognitive gait, and then for the obstacle-crossing gait and standard gait. The main effect of task and age was significant on the cost of task for stride length and speed (F > 3.368, P < 0.01), while the interaction effect was not significant.

Conclusion Gait of early childhood is influenced by interference tasks and age. Under interference tasks, gait cycle increases, while single stance phase, stride length, frequency and speed decrease; and task costs increase, and overall gait stability decrease. Cognitive tasks impact on gait greater than obstacle crossing, which may be due to the higher costs of tasks. In terms of age, gait exhibits a non-linear age trend.

Key words: children, interference, gait, task cost, stability

CLC Number:

R179

ZHAO Panchao, JI Zhongqiu, JIANG Guiping, WEN Ruixiang. Influence of different tasks on gait characteristics and task cost in early childhood[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1072-1082.

Figures/Tables 11

参数	任务	3岁组 (n = 30)	4岁组 (n = 32)	5岁组 (n = 30)	6岁组 (n = 30)	7岁组 (n = 30)	8岁组 (n = 30)	合计 (n = 182)
步态周期/s	标准	0.81±0.08	0.83±0.11	0.86±0.09	0.89±0.10	0.89±0.08	0.91±0.10^a,b	0.87±0.10
	认知	0.88±0.11	0.94±0.15	0.96±0.12	1.02±0.22^a	1.04±0.11^a	1.03±0.12^a	0.98±0.16^①
	越障	0.95±0.22	0.95±0.15	0.95±0.10	0.98±0.11	0.99±0.12	0.99±0.09	0.97±0.14^①
双支撑期百分比/%	标准	11.22±1.88	11.41±2.34	10.47±1.73^a	9.82±1.45^a,b	9.32±1.24^a,b	9.33±1.17^a,b	10.26±2.17
	认知	14.42±1.44^①	13.60±3.00^①	14.15±2.84^①	13.67±3.05^①	14.72±2.84^①	14.36±2.00^①	14.15±2.60
	越障	11.36±2.25	11.12±1.89	12.08±2.31^①	11.97±1.59^①	12.06±1.65^①	12.31±1.51^①	11.81±1.92
单支撑期百分比/%	标准	35.66±3.66	37.67±4.07^a	39.30±3.28^a	40.65±2.54^a,b	41.37±2.50^a,b	41.31±2.19^a,b	38.98±4.10
	认知	31.16±2.89^①	32.76±6.00^①	31.71±5.68^①	32.67±6.10^①	30.57±5.68^①	31.28±4.00^①	31.70±4.00
	越障	36.28±4.50	37.75±3.79	35.85±4.62^①	36.05±3.17^①	35.89±3.29^①	35.37±3.03^①	36.38±3.83
步幅/%	标准	76.65±12.05	76.50±8.31	83.11±9.31	83.02±12.86	86.48±9.40^a,b	83.79±7.97	81.53±10.66
	认知	72.02±10.25	71.07±14.64	73.90±12.01	74.41±11.45	72.29±10.70	71.23±8.09	72.46±11.31^①
	越障	75.5±11.54	79.99±10.49	80.57±15.39	84.31±11.57	82.83±11.15	83.17±7.49	81.05±11.68
步长/m	标准	0.40±0.06	0.42±0.06	0.49±0.06^a,b	0.50±0.08^a,b	0.54±0.06^a,b,c	0.56±0.04^a,b,c,d	0.49±0.08
	认知	0.37±0.06	0.37±0.05^①	0.43±0.07^①	0.46±0.08^①	0.41±0.17^①	0.47±0.05^a,b①	0.42±0.10
	越障	0.40±0.08	0.44±0.05^②	0.48±0.07^a②	0.51±0.10^a,b②	0.53±0.06^a,b②	0.55±0.05^a,b,c②	0.49±0.08
步宽/m	标准	0.10±0.02	0.10±0.03	0.08±0.02	0.07±0.02	0.07±0.02	0.07±0.02	0.08±0.04
	认知	0.08±0.02	0.09±0.02	0.09±0.02	0.09±0.02	0.09±0.06	0.08±0.02	0.09±0.03^①
	越障	0.09±0.03	0.09±0.03	0.08±0.02	0.10±0.02	0.09±0.03	0.08±0.03	0.09±0.04^①
步频/(min^-1)	标准	144.95±17.42	147.36±17.82	141.10±13.41	135.59±14.08^b	135.26±10.99^b	130.06±11.05^a,b	139.11±15.47
	认知	138.88±18.72	131.08±19.04	127.21±14.44	121.12±22.44^a	116.17±12.51^a,b	117.60±13.32^a,b	125.41±18.70^①
	越障	135.29±25.15	130.75±18.55	126.62±14.76	122.84±13.12	123.82±12.44	121.33±10.31^a	126.80±16.97^①
步速/ (%·s^-1)	标准	96.58±20.15	95.02±18.73	99.44±20.51	92.48±15.68	100.46±17.62	91.64±10.43	95.88±17.56
	认知	86.08±19.07	76.45±17.72	79.05±17.77	77.36±20.47	72.70±15.97	72.33±14.75	77.15±18.12^①
	越障	90.23±20.73	87.73±23.37	90.42±17.13	88.08±15.21	86.16±13.62	85.58±10.62	88.03±17.24^①②

参数	任务	3岁组 (n = 30)	4岁组 (n = 32)	5岁组 (n = 30)	6岁组 (n = 30)	7岁组 (n = 30)	8岁组 (n = 30)	合计 (n = 182)
髋关节活动度/°	标准	38.24±5.49	39.70±7.70	40.33±6.39	41.72±6.05	41.38±5.44	38.31±5.40	40.29±6.24
	认知	36.14±7.30	35.93±6.67	36.65±7.49	36.52±6.17	33.59±5.24	31.54±5.58^a,b,c,d	35.08±6.64^①
	越障	49.64±5.95	52.53±6.73	53.01±7.41	54.15±6.35	51.80±5.57	51.02±5.21	52.03±6.33^①②
膝关节活动度/°	标准	60.93±5.71	58.30±7.40	58.61±7.11	58.32±7.10	56.38±5.47	59.40±9.66	58.65±7.23
	认知	56.85±5.13^①	57.01±6.13	57.74±6.00	57.82±8.68	55.19±5.74	53.10±6.67^①	56.29±6.60
	越障	80.56±9.95^①②	85.24±13.27^①②	87.14±14.18^①②	83.34±12.24^①②	79.34±12.11^①②	84.94±8.54^①②	83.45±12.03
踝关节活动度/°	标准	97.53±10.79	100.50±10.68	103.78±8.88	106.73±13.05	101.03±9.48	98.25±11.23	101.30±11.07
	认知	94.82±14.47	94.75±14.20	94.78±18.97^①	95.73±14.75^①	89.38±12.87^①	81.65±17.75^a,b,c①	91.90±16.21
	越障	116.47±16.09^①②	129.06±17.64^a①②	131.8±14.11^a①②	123.03±15.92^①②	118.03±14.69^c①②	122.55±14.19^①②	123.55±16.26
髋关节最大角速度/(rad·s^-1)	标准	3.72±0.89	3.61±0.69	3.46±0.73	3.31±0.66	3.31±0.66	3.20±0.58^a	3.45±0.71
	认知	3.16±0.88^①	3.04±0.75^①	3.03±0.78^①	2.86±0.71^①	2.58±0.45^a①	2.35±0.57^a,b,c①	2.84±0.75
	越障	3.89±1.12^②	4.22±0.81^①②	4.18±0.83^①②	4.16±0.81^①②	4.35±0.69^①②	4.16±0.97^①②	4.16±0.88
膝关节最大角速度/(rad·s^-1)	标准	6.83±1.46	6.54±1.46	6.61±1.23	5.85±1.28	5.75±1.14	5.86±1.01	6.24±1.33
	认知	6.27±1.76	5.98±1.76	6.12±1.52	5.40±1.39	4.90±0.62^a,b,c①	4.86±0.72^a,b,c①	5.59±1.47
	越障	8.22±2.23^①②	8.35±1.53^①②	9.01±1.84^①②	8.38±1.62^①②	8.66±1.57^①②	9.25±1.60^①②	8.64±1.76
踝关节最大角速度/(rad·s^-1)	标准	11.49±2.78	10.32±2.83	10.78±1.92	10.49±2.26	10.60±2.33	9.80±2.10	10.58±2.42
	认知	10.31±3.03^①	9.96±2.78	9.03±2.69^①	8.82±1.88^①	8.25±1.76^①	7.48±1.57^①	8.98±2.52
	越障	11.94±2.82	12.97±4.54^①②	13.74±4.14^①②	12.34±3.34^②	12.91±4.59^①②	12.69±4.57^①②	12.77±4.05

参数	任务	3岁组 (n = 30)	4岁组 (n = 32)	5岁组 (n = 30)	6岁组 (n = 30)	7岁组 (n = 30)	8岁组 (n = 30)	合计 (n = 182)
外侧比目鱼肌	标准	15.86±5.09	12.97±5.04	16.01±5.53	11.04±4.55^a	11.96±4.12^a	12.79±4.56^a	15.86±5.09
	认知	12.80±2.62	11.02±5.18^a	11.49±3.16^a	11.39±3.70^a	9.93±2.40^a	9.77±2.72^a	11.16±3.91
	越障	18.73±5.15	16.10±6.41^①②	13.24±4.74^a	11.14±2.49^a,b	10.3±4.52^ab	9.14±3.87^a,b	12.95±5.70
内侧比目鱼肌	标准	17.89±4.51	15.72±5.70	17.14±3.68	14.94±3.72	17.31±4.73	14.50±3.11	16.22±4.44
	认知	13.24±4.78	13.73±3.34	14.45±4.49	13.54±3.49	13.47±4.60	12.84±3.33	13.60±4.41^①
	越障	22.09±4.20	17.86±5.52^a	16.85±4.56^a	15.12±2.70^a	17.63±4.26^a	13.19±4.53^a,b	17.03±5.10^②
外侧腓肠肌	标准	6.11±2.14	5.21±2.01	6.32±3.17	4.58±1.64^a	4.13±1.31^a,c	4.63±1.53^a,c	5.13±2.15
	认知	4.50±1.81	4.61±1.70	4.53±1.21	4.47±1.16^a	4.16±1.04^a,b,c	4.11±1.08^a,b,c	4.39±1.60^①
	越障	6.05±1.56	5.39±2.49	5.92±2.10	4.64±1.65	4.58±2.01	4.20±1.42^a	5.09±2.00^②
内侧腓肠肌	标准	16.32±5.85	14.37±5.98	15.98±5.85	12.76±4.86	12.30±3.80	13.77±3.40	14.21±5.15
	认知	12.47±5.31	12.31±3.65	12.12±4.95	10.53±2.85^a	10.09±3.64^a	10.33±3.27^a,b,c	11.42±4.50^①
	越障	16.01±3.87	14.53±6.57	16.07±5.56	13.41±4.68	14.66±5.22	15.87±5.93	15.09±5.39^②
胫骨前肌	标准	1.73±1.00	2.37±1.12	2.51±1.34	3.38±1.45^a	3.57±1.43^a	4.54±1.32^a,b,c	3.07±1.28
	认知	1.00±0.62	2.20±0.89^a	2.46±1.24^a	2.57±1.22^a	2.91±1.69^a	3.55±1.61^a	2.50±1.49^①
	越障	2.18±1.02	2.70±1.85	2.77±1.50	3.24±1.21	4.30±1.71^a,b,c	4.56±2.07^a,b,c	3.35±1.82^②
股二头肌	标准	8.51±3.88	8.99±4.36	8.11±5.23	6.08±2.57	7.06±2.53	6.39±2.56	7.50±3.71
	认知	7.84±3.73	6.88±3.06	6.83±3.31	5.22±2.45	5.17±1.90^a,b,c	5.49±2.24^a,b,c①	6.24±3.24
	越障	14.87±4.76^①②	13.67±4.56^①②	12.85±4.58^①②	9.32±4.05^a,b①②	9.48±2.70^a,b①②	9.57±4.54^a,b,c②	11.16±4.94
股直肌	标准	6.63±3.78	7.82±4.19	9.59±6.39	9.34±5.16	9.03±5.61	8.68±3.98	8.52±4.93
	认知	4.17±2.14	5.75±2.57	4.71±1.95^①	5.27±1.86^①	5.32±2.15^①	5.05±2.72^①	5.07±2.28
	越障	4.22±2.05	4.34±3.37^①	4.89±3.47^①	9.07±4.47^a,b,c②	9.51±5.92^a,b,c②	10.18±6.67^a,b,c②	7.17±5.31
臀大肌上束	标准	5.90±1.50	4.63±1.56	6.51±1.91	3.52±1.04^c	3.82±1.08	4.67±1.05	4.80±1.51
	认知	4.72±1.27	4.35±1.34	4.30±1.33^①	2.43±1.21^a,b,c	2.64±1.60^a,b,c	2.64±1.37^a,b,c①	3.48±1.65
	越障	10.06±4.56^①②	8.39±3.86^①②	7.94±4.08^②	4.30±2.90^a,b,c②	4.32±2.22^a,b,c	4.65±3.42^a,b,c	6.49±4.15

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组别	n	年龄/岁	身高/cm	体质量/kg	体质量指数/(kg·m^-2)
3岁组	30	3.80±0.15	103.30±4.70	17.46±2.38	16.37±2.09
4岁组	32	4.53±0.31	108.78±4.39^a	18.89±2.01	15.95±1.34
5岁组	30	5.53±0.32	116.28±5.08^a,b	21.70±3.18^a	16.02±1.94
6岁组	30	6.60±0.32	122.93±4.60^a,b,c	25.58±4.43^a,b,c	16.88±2.36
7岁组	30	7.52±0.26	126.33±6.03^a,b,c	26.49±6.51^a,b,c	16.43±2.82
8岁组	30	8.40±0.23	132.65±5.23^a,b,c,d,e	32.39±6.87^a,b,c,d,e	18.34±3.54^a,b,c
F值		1263.063	147.790	44.023	4.116
P值		< 0.001	< 0.001	< 0.001	0.001

Davis模型	Anybody模型
第七颈椎	左/右头前点
左/右肩峰	左/右头后点
左/右髂前上棘	锁骨中点
两侧髂后上棘中点	第十胸椎
左/右股骨大转子	胸骨剑突
左/右大腿中点	左/右髂前上棘
左/右胫骨外侧髁	左/右髂后上棘
左/右腓骨小头	左/右大腿下1/3
左/右小腿中点	左/右胫骨外侧髁
左/右外踝	左/右小腿下1/3
左/右足跟	左/右外踝
左/右第五跖骨	左/右足跟
	左/右第二跖骨
	左/右第五跖骨

因变量	主效应/交互效应	自由度	F值	P值	η_p²值
步态周期	任务	2	68.746	< 0.001	0.281
	年龄	5	5.206	< 0.001	0.129
	任务×年龄	10	1.646	0.092	0.045
双支撑期百分比	任务	2	185.595	< 0.001	0.513
	年龄	5	2.321	0.045	0.062
	任务×年龄	10	10.221	< 0.001	0.225
单支撑期百分比	任务	2	197.589	< 0.001	0.529
	年龄	5	2.509	0.032	0.067
	任务×年龄	10	9.902	< 0.001	0.220
步幅	任务	2	62.824	< 0.001	0.263
	年龄	5	2.642	0.025	0.070
	任务×年龄	10	2.025	0.077	0.054
步长	任务	2	71.044	< 0.001	0.288
	年龄	5	26.922	< 0.001	0.433
	任务×年龄	10	3.040	0.001	0.080
步宽	任务	2	5.167	0.006	0.029
	年龄	5	0.969	0.438	0.027
	任务×年龄	10	1.362	0.196	0.037
步频	任务	2	71.164	< 0.001	0.288
	年龄	5	8.396	< 0.001	0.193
	任务×年龄	10	1.502	0.137	0.041
步速	任务	2	86.575	< 0.001	0.330
	年龄	5	1.383	0.233	0.038
	任务×年龄	10	1.546	0.122	0.042

因变量	主效应/交互效应	自由度	F值	P值	η_p²值
髋关节活动度	任务	2	504.092	< 0.001	0.741
	年龄	5	2.927	0.015	0.077
	任务×年龄	10	1.740	0.071	0.047
膝关节活动度	任务	2	813.462	< 0.001	0.822
	年龄	5	1.324	0.256	0.036
	任务×年龄	10	2.534	0.006	0.067
踝关节活动度	任务	2	308.044	< 0.001	0.636
	年龄	5	4.556	0.001	0.115
	任务×年龄	10	3.357	< 0.001	0.087
髋关节最大角速度	任务	2	176.724	< 0.001	0.501
	年龄	5	2.359	0.042	0.063
	任务×年龄	10	3.412	< 0.001	0.088
膝关节最大角速度	任务	2	271.557	< 0.001	0.607
	年龄	5	3.074	0.011	0.080
	任务×年龄	10	3.983	< 0.001	0.102
踝关节最大角速度	任务	2	83.019	< 0.001	0.321
	年龄	5	1.798	0.116	0.049
	任务×年龄	10	2.066	0.026	0.055

因变量	主效应/交互效应	自由度	F值	P值	η_p²值
外侧比目鱼肌	任务	2	4.032	0.019	0.031
	年龄	5	16.779	< 0.001	0.404
	任务×年龄	10	2.727	0.003	0.099
内侧比目鱼肌	任务	2	19.582	< 0.001	0.136
	年龄	5	11.581	< 0.001	0.318
	任务×年龄	10	1.841	0.054	0.069
外侧腓肠肌	任务	2	24.041	< 0.001	0.162
	年龄	5	13.637	< 0.001	0.355
	任务×年龄	10	0.463	0.913	0.018
内侧腓肠肌	任务	2	34.243	< 0.001	0.216
	年龄	5	5.181	< 0.001	0.173
	任务×年龄	10	2.076	0.073	0.077
胫骨前肌	任务	2	11.809	< 0.001	0.087
	年龄	5	20.673	< 0.001	0.455
	任务×年龄	10	1.720	0.077	0.065
股二头肌	任务	2	110.932	< 0.001	0.472
	年龄	5	12.696	< 0.001	0.339
	任务×年龄	10	2.189	0.019	0.081
股直肌	任务	2	26.014	< 0.001	0.173
	年龄	5	4.705	0.001	0.159
	任务×年龄	10	3.476	< 0.001	0.123
臀大肌上束	任务	2	46.110	< 0.001	0.271
	年龄	5	14.362	< 0.001	0.367
	任务×年龄	10	3.287	0.001	0.117

Influence of different tasks on gait characteristics and task cost in early childhood

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因变量	主效应/交互效应	自由度	F值	P值	η_p²值
步速TC	任务	1	18.882	< 0.001	0.097
	年龄	5	4.217	0.001	0.107
	任务×年龄	5	0.307	0.908	0.009
步幅TC	任务	1	32.964	< 0.001	0.158
	年龄	5	3.368	0.006	0.087
	任务×年龄	5	0.275	0.926	0.008

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组别	n	标准		认知		越障
组别	n	步速	步幅	步速	步幅	步速	步幅
3岁组	30	16.05	15.09	22.87	16.75	22.08	14.68
4岁组	32	19.31	10.95	21.34	17.32	22.98	12.40
5岁组	30	16.92	11.34	19.03	14.92	19.11	11.33
6岁组	30	16.67	15.50	17.85	14.18	17.34	13.43
7岁组	30	16.46	10.98	15.09	14.91	15.27	13.33
8岁组	30	11.50	9.46	14.60	11.55	12.60	9.65
合计	182	16.15	12.22	18.46	14.94	18.23	12.47

组别	n	步速		步幅
组别	n	认知	越障	认知	越障
3岁组	30	22.87±9.25	18.99±11.34	16.97±7.02	12.08±9.72
4岁组	32	18.81±8.40	15.73±13.15	15.13±7.63	11.61±8.57
5岁组	30	19.33±6.45	16.59±10.77	13.45±6.01	9.23±5.96
6岁组	30	18.20±10.95	12.49±8.01^a	12.86±5.81	10.11±7.52
7岁组	30	17.91±9.28	13.81±12.12	12.69±5.41^a	7.85±9.29
8岁组	30	16.12±7.06	10.21±6.29^a	12.53±5.71^a	7.30±7.78
合计	182	18.86±8.80^①	14.63±10.80	13.95±6.45^①	9.71±8.31