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不同年龄组及膝关节骨关节炎患者在步态过程中的矢状面负荷反应。

Sagittal plane loading response during gait in different age groups and in people with knee osteoarthritis.

作者信息

Chen Carl P C, Chen Max J L, Pei Yu-Cheng, Lew Henry L, Wong Pong-Yuen, Tang Simon F T

机构信息

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-yuan, Taiwan.

出版信息

Am J Phys Med Rehabil. 2003 Apr;82(4):307-12. doi: 10.1097/01.PHM.0000056987.33630.56.

Abstract

OBJECTIVE

To investigate the gait patterns and the sagittal ground reaction forces in different age groups and in people with knee osteoarthritis.

DESIGN

Motion analysis and force platform data were collected for a total of 55 female subjects capable of independent ambulation. Subjects were divided into three groups consisting of the control group, the elderly group, and the osteoarthritis knee group. Gait parameters of walking velocity, cadence, step length, stride time, single- and double-support time, and sagittal ground reaction forces were obtained during comfortable walking speed. Gait analysis was performed in a tertiary hospital's gait laboratory. Variables were analyzed using a univariate repeated-measures analysis of variance. Statistical significance was set at a value of P < 0.05.

RESULTS

The osteoarthritis knee group had slower walking velocity, lower cadence, and longer stride time as compared with the elderly and young control groups (P < 0.05). In ground reaction force studies, the first peak time, expressed in percentage of gait cycle, was significantly longer in the osteoarthritis knee group (20.8 +/- 3.2) as compared with the elderly (17.8 +/- 2.0) and young control groups (17.1 +/- 1.8, P < 0.01). The force during time of minimal midstance was larger in the osteoarthritis knee group (90.9 +/- 5.3) as compared with the elderly and young control groups (P < 0.05). The second peak force was significantly smaller in the osteoarthritis knee group as compared with the young control group (P < 0.01). The force change in the midfoot region in the osteoarthritis knee and elderly groups revealed more loading force onto the midfoot region during midstance as compared with the young control group (P < 0.01).

CONCLUSION

Gait parameters in the elderly and osteoarthritis knee patients were characterized by slower walking velocity, lower cadence, shorter step length, longer stride time, and longer double-support time. Less heel contact and push-off forces were noticed in these two groups, with more loading force onto the midfoot during midstance.

摘要

目的

研究不同年龄组以及膝骨关节炎患者的步态模式和矢状面地面反作用力。

设计

收集了总共55名能够独立行走的女性受试者的运动分析和力平台数据。受试者被分为三组,即对照组、老年组和膝骨关节炎组。在舒适步行速度下获取步行速度、步频、步长、步幅时间、单支撑和双支撑时间以及矢状面地面反作用力等步态参数。在一家三级医院的步态实验室进行步态分析。使用单变量重复测量方差分析对变量进行分析。统计学显著性设定为P < 0.05。

结果

与老年和年轻对照组相比,膝骨关节炎组的步行速度较慢、步频较低且步幅时间较长(P < 0.05)。在地面反作用力研究中,以步态周期百分比表示的第一个峰值时间,膝骨关节炎组(20.8 +/- 3.2)明显长于老年组(17.8 +/- 2.0)和年轻对照组(17.1 +/- 1.8,P < 0.01)。与老年和年轻对照组相比,膝骨关节炎组在最小支撑中期的力更大(90.9 +/- 5.3,P < 0.05)。与年轻对照组相比,膝骨关节炎组的第二个峰值力明显较小(P < 0.01)。与年轻对照组相比,膝骨关节炎组和老年组中足区域的力变化显示在支撑中期中足区域承受的负荷力更大(P < 0.01)。

结论

老年人和膝骨关节炎患者的步态参数特点为步行速度较慢、步频较低、步长较短、步幅时间较长以及双支撑时间较长。这两组中足跟接触和蹬地力较小,在支撑中期中足承受的负荷力更大。

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