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膝关节骨关节炎患者的内翻-外翻运动及功能能力

Varus-valgus motion and functional ability in patients with knee osteoarthritis.

作者信息

van der Esch M, Steultjens M, Harlaar J, Wolterbeek N, Knol D, Dekker J

机构信息

Jan van Breemen Institute, Center for Rheumatology and Rehabilitation. Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands.

出版信息

Ann Rheum Dis. 2008 Apr;67(4):471-7. doi: 10.1136/ard.2007.071258. Epub 2007 Jun 29.

Abstract

OBJECTIVE

To assess the relationship between knee varus-valgus motion and functional ability, and the impact of knee varus-valgus motion on the relationship between muscle strength and functional ability in patients with osteoarthritis (OA) of the knee.

METHODS

Sixty-three patients with knee OA were tested. Varus-valgus motion was assessed by optoelectronic recording and three-dimensional motion analysis. Functional ability was assessed by observation, using a 100 m walking test, a Get Up and Go test, and WOMAC questionnaire. Muscle strength was measured by a computer-driven isokinetic dynamometer. Regression analyses were performed to assess the relationships between varus-valgus motion and functional ability, and to assess the impact of varus-valgus motion on the relationship between muscle strength and functional ability.

RESULTS

In patients with high varus-valgus range of motion, muscle weakness was associated with a stronger reduction in functional ability (ie, longer walking time and Get Up and Go time) than in patients with low varus-valgus range of motion. A pronounced varus position and a difference between the left and right knees in varus-valgus position were related with reduced functional ability.

CONCLUSIONS

In patients with knee OA with high varus-valgus range of motion, muscle weakness has a stronger impact on functional ability than in patients with low varus-valgus range of motion. Patients with knee OA with more pronounced varus knees during walking show a stronger reduction in functional ability than patients with less pronounced varus knees or with valgus knees.

摘要

目的

评估膝关节内翻-外翻运动与功能能力之间的关系,以及膝关节内翻-外翻运动对膝骨关节炎(OA)患者肌肉力量与功能能力关系的影响。

方法

对63例膝OA患者进行测试。通过光电记录和三维运动分析评估内翻-外翻运动。通过观察、100米步行测试、起立行走测试和WOMAC问卷评估功能能力。使用计算机驱动的等速测力计测量肌肉力量。进行回归分析以评估内翻-外翻运动与功能能力之间的关系,并评估内翻-外翻运动对肌肉力量与功能能力关系的影响。

结果

在内翻-外翻运动范围较大的患者中,与内翻-外翻运动范围较小的患者相比,肌肉无力与功能能力的下降更为明显(即步行时间和起立行走时间更长)。明显的内翻位置以及双膝在内翻-外翻位置上的差异与功能能力下降有关。

结论

在膝OA且内翻-外翻运动范围较大的患者中,与内翻-外翻运动范围较小的患者相比,肌肉无力对功能能力的影响更大。在行走过程中内翻更明显的膝OA患者,与内翻不那么明显或为外翻膝的患者相比,功能能力下降更明显。

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