Lynn Scott K, Kajaks Tara, Costigan Patrick A
Queen's University, School Of Kinesiology and Health Studies, Kingston, Ontario, Canada K7L 3N6.
J Sci Med Sport. 2008 Sep;11(5):444-51. doi: 10.1016/j.jsams.2007.03.004. Epub 2007 Sep 4.
It has been hypothesised that those with medial compartment knee osteoarthritis tend to externally rotate their foot during gait in order to unload the diseased compartment. This has been found to decrease the adduction moment at the knee during late stance, although the effects of foot rotation on shear forces at the knee have not yet been determined. Also, the effects of internal foot rotation on the knee during gait are not clear. This study performed a gait analysis on 11 healthy participants (M: 6; mean age 22.9+/-1.8 years) in three conditions: (1) natural foot rotation position; (2) internal foot rotation and (3) external foot rotation. Three-dimensional gait analysis calculated the knee adduction moment and lateral-medial shear force for all three foot rotation conditions. Internal rotation of the foot increased the knee adduction moment and lateral-medial shear force magnitude during late stance, while external rotation of the foot decreased the magnitude of both these measures. This implies that walking with an externally and internally rotated foot may unload the diseased compartment for those with medial and lateral compartment knee OA, respectively. Also, the relationship of foot rotation angle to the adduction moment and lateral-medial shear force was strengthened when data were corrected for the subject's normal walking condition. Knee OA subject data revealed that they were able to reduce the knee adduction moment more than normal subjects during late stance, indicating that other factors besides the rotation of the foot need to be investigated.
有假说认为，患有膝关节内侧间室骨关节炎的人在步态中倾向于使足部向外旋转，以便减轻患病间室的负荷。研究发现，这会在站立后期降低膝关节的内收力矩，不过足部旋转对膝关节剪切力的影响尚未确定。此外，足部向内旋转在步态中对膝关节的影响也不明确。本研究对11名健康参与者（男性6名；平均年龄22.9±1.8岁）在三种情况下进行了步态分析：（1）自然足部旋转位置；（2）足部向内旋转；（3）足部向外旋转。三维步态分析计算了所有三种足部旋转情况下的膝关节内收力矩和内外侧剪切力。足部向内旋转会增加站立后期的膝关节内收力矩和内外侧剪切力大小，而足部向外旋转则会降低这两种测量值的大小。这意味着，对于患有膝关节内侧和外侧间室骨关节炎的人来说，分别用足部向外和向内旋转的方式行走可能会减轻患病间室的负荷。此外，当对数据进行受试者正常行走状态校正后，足部旋转角度与内收力矩和内外侧剪切力之间的关系得到了加强。膝关节骨关节炎受试者的数据显示，他们在站立后期能够比正常受试者更多地降低膝关节内收力矩，这表明除了足部旋转之外，还需要研究其他因素。
