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通过步态运动学检测前交叉韧带断裂后功能适应不良者的恢复情况。

Recovery in functional non-copers following anterior cruciate ligament rupture as detected by gait kinematics.

作者信息

Button Kate, van Deursen Robert, Price Patricia

机构信息

Department of Physiotherapy, School of Healthcare Studies, Cardiff University, Ty Dewi Sant, Cardiff CF144XN, UK.

出版信息

Phys Ther Sport. 2008 May;9(2):97-104. doi: 10.1016/j.ptsp.2008.03.001.

DOI:10.1016/j.ptsp.2008.03.001
PMID:19083709
Abstract

OBJECTIVES

To evaluate if gait compensation strategies for selected kinematic variables can be identified in anterior cruciate ligament (ACL) deficient non-copers using two-dimensional (2D) clinical gait analysis.

DESIGN

Prospective observational design, repeated measures.

SETTING

University hospital, out-patients department.

PATIENTS

Sixty-three patients that attended the acute knee screening service were diagnosed with an acute ACL rupture and consented to participate. A sub-set of 15 copers/adapters and 13 non-copers were eligible for final analysis because they were contactable for sub-classification and had gait analysis at 1 and 4 months post-injury.

MAIN OUTCOME MEASURES

2D video gait analysis for sagittal plane hip, knee and ankle kinematics and time-distance variables.

RESULTS

At 4 months post-injury non-copers demonstrated significantly less recovery of knee angle (F((1,1))=5.79, p<0.024), hip displacement angle (F((1,1))=4.89, p<0.036), step length (F((1,1)) =6.80, p=0.015), cadence (F((1,1))=5.85, p=0.023) and velocity (F((1,1))=10.89, p=0.003), compared to copers/adapters. Also non-copers demonstrated altered correlations between gait parameters.

CONCLUSION

At 4 months post-injury non-copers had an inferior gait performance compared to copers/adapters for kinematics and time-distance variables. 2D clinical kinematic gait analysis, particularly of the hip and knee can inform early rehabilitation techniques and monitor recovery.

摘要

目的

运用二维临床步态分析,评估在前交叉韧带(ACL)损伤的非适应者中,能否识别出针对特定运动学变量的步态补偿策略。

设计

前瞻性观察性设计,重复测量。

地点

大学医院门诊部。

患者

63名参加急性膝关节筛查服务的患者被诊断为急性ACL断裂,并同意参与研究。15名适应者/调整者和13名非适应者组成的亚组符合最终分析条件,因为他们可被联系进行亚分类,且在受伤后1个月和4个月进行了步态分析。

主要观察指标

矢状面髋、膝和踝关节运动学及时间-距离变量的二维视频步态分析。

结果

与适应者/调整者相比,在受伤后4个月时,非适应者的膝关节角度恢复明显较少(F((1,1)) = 5.79,p < 0.024)、髋关节位移角度(F((1,1)) = 4.89,p < 0.036)、步长(F((1,1)) = 6.80,p = 0.015)、步频(F((1,1)) = 5.85,p = 0.023)和速度(F((1,1)) = 10.89,p = 0.003)。此外,非适应者的步态参数之间的相关性也发生了改变。

结论

在受伤后4个月,与适应者/调整者相比,非适应者在运动学和时间-距离变量方面的步态表现较差。二维临床运动学步态分析,尤其是髋部和膝部的分析,可为早期康复技术提供依据并监测恢复情况。

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