Department of Surgery, Duke University, Durham, NC, USA.
Aging Clin Exp Res. 2009 Dec;21(6):463-9. doi: 10.1007/BF03327442.
This study examines racial differences in gait mechanics in persons with knee osteoarthritis and the influence of anthropometrics, educational level, radiographic disease severity (rOA), and self-report measures of pain and disability on racial differences in gait.
One hundred seventy five (64 black and 111 white) adults with radiographic knee OA were tested. 3-D kinematic and kinetic data were collected while subjects walked at two self-selected speeds (normal and fast). Anthropometric data, radiographic level of OA, and self-report measures of pain and disability were also collected. Gait patterns were compared across groups and within groups.
Black and white subjects did not differ significantly in radiographic OA. However, blacks walked significantly more slowly when asked to walk fast. At the normal speed, blacks had a smaller knee range of motion and loading rate than whites. Blacks also took longer to reach their peak maximum ground reaction force than whites. Within black subjects variations in gait mechanics were primarily explained by BMI, rOA, selfreported psychological disability, and pain self-efficacy. In white subjects, variations in gait mechanics were primarily explained by weight, age, velocity, psychological disability, and self-efficacy.
Blacks in this study had a pattern of gait mechanics generally associated with high levels of osteoarthritis, though they did not differ significantly in rOA from whites. The variability in gait patterns exhibited by blacks was most strongly related to variance in walking speed, anthropometrics, and perceived physical ability. Taken together, these results suggest that race is an important factor that must be considered in the treatment and study of osteoarthritis.
本研究旨在探讨膝骨关节炎患者步态力学的种族差异，以及人体测量学、教育水平、影像学疾病严重程度（rOA）、疼痛和残疾的自我报告测量值对步态种族差异的影响。
175 名（64 名黑人，111 名白人）有影像学膝骨关节炎的成年人接受了测试。当受试者以两种自我选择的速度（正常和快速）行走时，收集了 3D 运动学和动力学数据。还收集了人体测量学数据、OA 的放射学水平以及疼痛和残疾的自我报告测量值。比较了组间和组内的步态模式。
黑人与白人在影像学 OA 方面无显著差异。然而，当要求黑人快速行走时，他们走得明显较慢。在正常速度下，黑人的膝关节活动范围和加载率比白人小。黑人达到最大地面反力峰值的时间也比白人长。在黑人受试者中，步态力学的变化主要由 BMI、rOA、自我报告的心理残疾和疼痛自我效能解释。在白人受试者中，步态力学的变化主要由体重、年龄、速度、心理残疾和自我效能解释。
本研究中的黑人表现出一种通常与高水平骨关节炎相关的步态力学模式，尽管他们在 rOA 方面与白人没有显著差异。黑人表现出的步态模式的可变性与行走速度、人体测量学和感知身体能力的变异性密切相关。综上所述，这些结果表明，种族是治疗和研究骨关节炎时必须考虑的一个重要因素。
