Kito Nobuhiro, Shinkoda Koichi, Yamasaki Takahiro, Kanemura Naohiko, Anan Masaya, Okanishi Natsuko, Ozawa Junya, Moriyama Hideki
Department of Physical Therapy, Hiroshima International University, 555-36 Kurosegakuendai, Higashi-Hiroshima-shi, Hiroshima, 737-0112, Japan.
Clin Biomech (Bristol). 2010 Nov;25(9):914-9. doi: 10.1016/j.clinbiomech.2010.06.008. Epub 2010 Jul 21.
An increase in the knee adduction moment is one of the risk factors of medial knee osteoarthritis. This study examined the relationship between knee adduction moment and self-reported pain and disability. We also investigated the influence of pain on the relationships between knee adduction moment and gait performance and disability.
Thirty-eight Japanese women with medial knee osteoarthritis participated in this study (66.37 years (41-79 years)). Gait analysis involved the measurement of the external knee adduction moment impulse in the stance duration and during 3 subdivisions of stance. The total, pain and stiffness, and physical function Japanese Knee Osteoarthritis Measure scores were determined.
The pain and stiffness, physical function, and total scores were positively correlated with the knee adduction moment impulses in the stance duration, and initial and second double support interval, and single limb support interval. The knee adduction moment impulse during the stance duration was related to the pain and stiffness subscale and gait velocity. The pain and stiffness subscale was related to the physical function subscale.
Our results suggest that increasing in the knee adduction moment impulse, a proxy for loading on the medial compartment of the knee, is related to increased pain during weight-bearing activities such as walking, thereby restricting walking performance and causing disability by reducing gait velocity. Thus, the reduction in the knee adduction moment impulse during gait may result in pain relief and may serve as a conservative treatment option with disease-modifying potential.
膝关节内收力矩增加是膝关节内侧骨关节炎的危险因素之一。本研究探讨了膝关节内收力矩与自我报告的疼痛及功能障碍之间的关系。我们还研究了疼痛对膝关节内收力矩与步态表现及功能障碍之间关系的影响。
38名患有膝关节内侧骨关节炎的日本女性参与了本研究（年龄66.37岁（41 - 79岁））。步态分析包括测量站立期以及站立期三个细分阶段的膝关节外展力矩冲量。测定了日本膝关节骨关节炎量表的总分、疼痛与僵硬分以及身体功能分。
疼痛与僵硬分、身体功能分以及总分与站立期、初始和第二个双支撑期以及单腿支撑期的膝关节内收力矩冲量呈正相关。站立期的膝关节内收力矩冲量与疼痛和僵硬分量表以及步速有关。疼痛和僵硬分量表与身体功能分量表有关。
我们的结果表明，膝关节内收力矩冲量增加（膝关节内侧间室负荷的一个指标）与行走等负重活动时疼痛加剧有关，从而限制行走表现并通过降低步速导致功能障碍。因此，步态中膝关节内收力矩冲量的降低可能会缓解疼痛，并可能作为一种具有疾病改善潜力的保守治疗选择。
