Ford Kevin R, Myer Gregory D, Melson Paula G, Darnell Shannon C, Brunner Hermine I, Hewett Timothy E
Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH 45229, USA.
Int J Rheumatol. 2009;2009:478526. doi: 10.1155/2009/478526. Epub 2010 Jan 27.
Objective. The purpose of this study was to determine if high functioning children with Juvenile Idiopathic Arthritis (JIA) with minimal disease activity have different biomechanics during high loading tasks compared to controls. Patients were included if they had minimal inflammation documented in one or both knees. Methods. The subject groups consisted of eleven patients with JIA and eleven sex, age, height, and weight matched controls. Sagittal plane kinematic and kinetics were calculated during a drop vertical jump maneuver. The Child Health Assessment Questionnaire (CHAQ) was collected on each patient with JIA. Results. The subjects with JIA had increased knee (P = .011) and hip flexion (P < .001) compared to control subjects. Subjects with JIA also demonstrated decreased knee extensor moments during take-off (P = .028) and ankle plantar flexor moments during landing (P = .024) and take-off (P = .004). In the JIA group, increased hip extensor moments were predictive of increased disability (R(2) = .477, SEE = .131). Conclusions. Patients with JIA may demonstrate underlying biomechanical deviations compared to controls. In addition, biomechanical assessment of hip extensor mechanics during dynamic tasks may provide an objective assessment tool to determine overall function in patients with JIA.
目的。本研究的目的是确定与对照组相比,患有幼年特发性关节炎(JIA)且疾病活动度极低的高功能儿童在高负荷任务期间是否具有不同的生物力学特征。若患者一个或两个膝盖的炎症记录极少,则纳入研究。方法。研究对象分为两组,一组为11名患有JIA的患者,另一组为11名性别、年龄、身高和体重相匹配的对照组。在垂直下落跳跃动作过程中计算矢状面运动学和动力学参数。收集每位JIA患者的儿童健康评估问卷(CHAQ)。结果。与对照组相比,患有JIA的受试者膝关节(P = 0.011)和髋关节屈曲(P < 0.001)增加。患有JIA的受试者在起跳时膝关节伸肌力矩降低(P = 0.028),在着陆和起跳时踝关节跖屈肌力矩降低(P = 0.024和P = 0.004)。在JIA组中,髋关节伸肌力矩增加预示着残疾程度增加(R² = 0.477,标准误 = 0.131)。结论。与对照组相比,患有JIA的患者可能存在潜在的生物力学偏差。此外,在动态任务期间对髋关节伸肌力学进行生物力学评估可能为确定JIA患者的整体功能提供一种客观评估工具。