开发膝关节每日累积负荷的估算方法:检验测试-再测试可靠性。

Developing an estimate of daily cumulative loading for the knee: examining test-retest reliability.

机构信息

Wolf Orthopaedic Biomechanics Laboratory and School of Physical Therapy, University of Western Ontario, London, ON, Canada.

出版信息

Gait Posture. 2009 Nov;30(4):497-501. doi: 10.1016/j.gaitpost.2009.07.118. Epub 2009 Aug 18.

Abstract

Although the knee adduction moment during gait is a valid and reliable proxy for the dynamic load on the medial compartment of the knee, it represents exposure to loading during one stride only. In contrast, a measure that incorporates both the nature and frequency of loading throughout daily activities might provide additional insight into the effects of cumulative knee loading. The purpose of this study was to introduce a new representation of daily cumulative knee loading and examine its test-retest reliability. Thirty healthy adults participated. Cumulative knee loading was calculated on two testing periods from the mean external knee adduction moment stance phase impulse, measured with a three-dimensional motion capture system over five walking trials, and mean steps/day, measured with a unidimensional accelerometer over one week. Analysis for test-retest reliability included Bland-Altman graphs, intraclass correlation coefficients (ICC 2,1) and standard errors of measurements (SEM). The ICC values for cumulative knee loading, adduction impulse and steps/day ranged from 0.84 to 0.89. Bland-Altman plots suggested daily cumulative knee loading and steps/day measures were less reliable at higher values. The SEM values were 9.67 kNm s, 1.45 Nm s and 1043 steps/day for cumulative knee loading, adduction impulse and steps/day, respectively. Daily cumulative knee loading is reliable and provides a stable measure of the total exposure to knee loading. These findings support further study of cumulative knee loading to determine its potential clinical importance.

摘要

尽管步态中的膝关节内收力矩是膝关节内侧间室动态负荷的有效且可靠的替代指标,但它仅代表单步运动中的负荷暴露情况。相比之下,一种能够综合考虑日常活动中负荷的性质和频率的测量方法,可能会提供更多关于累积膝关节负荷影响的信息。本研究旨在介绍一种新的日常累积膝关节负荷表示方法,并检验其测试-重测信度。共有 30 名健康成年人参与了这项研究。在两次测试期间,通过三维运动捕捉系统测量的五个步行试验中的平均膝关节外展力矩支撑相冲量和通过一维加速度计测量的一周内的平均步数/天,计算出累积膝关节负荷。测试-重测信度分析包括 Bland-Altman 图、组内相关系数(ICC 2,1)和测量标准误差(SEM)。累积膝关节负荷、内收冲量和步数/天的 ICC 值范围为 0.84 至 0.89。Bland-Altman 图表明,在较高值时,每日累积膝关节负荷和步数/天的测量值不太可靠。累积膝关节负荷、内收冲量和步数/天的 SEM 值分别为 9.67 kNm s、1.45 Nm s 和 1043 步/天。每日累积膝关节负荷具有可靠性,并提供了膝关节负荷总暴露量的稳定测量方法。这些发现支持进一步研究累积膝关节负荷,以确定其潜在的临床重要性。

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