Hooper D M, Morrissey M C, Crookenden R, Ireland J, Beacon J P
Spinal Concepts Inc., 12012 Technology Blvd., Suite 100, Austin, TX, USA.
Clin Biomech (Bristol). 2002 Mar;17(3):227-33. doi: 10.1016/s0268-0033(02)00002-5.
A retrospective analysis was performed to assess gait in individuals with a long history of posterior knee instability.
Descriptive study.
There are few studies in the literature concerning evaluation of the biomechanics of the knee in patients with knee posterior instability.
Nine individuals with posterior knee instability and a matched control group of uninjured subjects were tested in regards to knee kinematics and kinetics while walking and ascending and descending stairs. The mean follow up time for the individuals with posterior instability was 11.1 years. Individual satisfaction with the knee was measured by having participants complete the Flandry (also known as Hughston Clinic) self-assessment questionnaire.
It was found that patients with knee posterior instability who indicated a higher level of satisfaction on the Flandry score walked in a manner that demonstrated greater peak knee extensor torque during stance phase, while less satisfied patients with knee posterior instability demonstrated lower peak knee extensor torque. There was a significant correlation between the self-assessment score and the peak knee extensor torque during level walking (P=0.003). During stair ascent and descent, patients with posterior instability averaged lower knee extensor torque and power than the control subjects, but those differences were only statistically significant in power while descending stairs (P=0.048).
Individuals with chronic knee posterior instability modify their gait, and the adaptation can be predicted based upon the individuals self-assessment of their knee using the Flandry questionnaire.
These data suggest that gait retraining may be a valuable addition to the traditional muscle strengthening programs, which are commonly used during conservative management of knee posterior instability.
进行一项回顾性分析，以评估有长期膝关节后向不稳定病史的个体的步态。
描述性研究。
关于膝关节后向不稳定患者膝关节生物力学评估的文献研究较少。
对9名膝关节后向不稳定患者和一组匹配的未受伤对照受试者进行测试，测量他们行走、上下楼梯时的膝关节运动学和动力学参数。膝关节后向不稳定患者的平均随访时间为11.1年。通过让参与者完成Flandry（也称为休斯顿诊所）自我评估问卷来衡量个体对膝关节的满意度。
发现Flandry评分显示满意度较高的膝关节后向不稳定患者在站立期行走时表现出更大的膝关节伸肌峰值扭矩，而满意度较低的膝关节后向不稳定患者则表现出较低的膝关节伸肌峰值扭矩。自我评估得分与平地上行走时的膝关节伸肌峰值扭矩之间存在显著相关性（P = 0.003）。在上下楼梯过程中，后向不稳定患者的膝关节伸肌扭矩和功率平均低于对照受试者，但这些差异仅在下楼时的功率方面具有统计学意义（P = 0.048）。
慢性膝关节后向不稳定个体的步态会发生改变，并且可以根据个体使用Flandry问卷对其膝关节的自我评估来预测这种适应性变化。
这些数据表明，步态再训练可能是传统肌肉强化计划的一项有价值的补充，传统肌肉强化计划常用于膝关节后向不稳定的保守治疗中。
