Department of Community Health and Family Medicine, Duke University, DUMC 104002, Durham, NC 27705, USA.
Phys Ther. 2011 Aug;91(8):1235-43. doi: 10.2522/ptj.20100324. Epub 2011 Jun 16.
The majority of research on gait mechanics in knee osteoarthritis has focused on people with medial compartment involvement. As a result, little is known about the gait mechanics of people with the less common, lateral compartment disease.
The objective of this study was to compare walking mechanics--specifically, differences in frontal-plane lower-extremity kinematics and kinetics--in people with medial knee osteoarthritis, people with lateral knee osteoarthritis, and people who were healthy.
A cross-sectional design was used.
Fifteen people with medial knee osteoarthritis, 15 people with lateral knee osteoarthritis, and 15 people who were healthy (control group) were recruited for the study. All participants underwent a gait analysis at an intentional walking speed. The variables of interest for the study were peak frontal-plane moments and angles and angular excursions of the lower extremity during the stance phase of gait. Data were statistically analyzed with a one-way analysis of variance.
Participants with lateral knee osteoarthritis exhibited significantly less knee adduction excursion, lower peak knee abduction moment, and lower peak rear-foot eversion compared with the control group and the medial knee osteoarthritis group.
Participants in the control group were approximately 10 years younger than participants with knee osteoarthritis. Despite this difference, neither body mass index nor gait speed, each of which is a factor with a stronger influence on gait mechanics, differed among the groups.
Participants with lateral knee osteoarthritis exhibited frontal-plane gait mechanics at the knee and rear foot that were different from those of participants with medial knee osteoarthritis. The results of this study may guide the development of interventions specific to treating people with lateral knee osteoarthritis.
大多数膝关节骨关节炎的步态力学研究都集中在内侧间室受累的人群。因此,对于外侧间室疾病较少见的人群的步态力学知之甚少。
本研究的目的是比较膝关节内侧骨关节炎、膝关节外侧骨关节炎和健康人群的行走力学,特别是额状面下肢运动学和动力学的差异。
采用横断面设计。
本研究招募了 15 名膝关节内侧骨关节炎患者、15 名膝关节外侧骨关节炎患者和 15 名健康对照者(对照组)。所有参与者均以自主行走速度进行步态分析。研究的感兴趣变量为步态站立相时额状面下肢的峰值力矩和角度以及下肢的角度活动度。数据采用单因素方差分析进行统计学分析。
与对照组和膝关节内侧骨关节炎组相比,膝关节外侧骨关节炎患者的膝关节内收活动度明显减小,膝关节外展峰值力矩和后足外翻峰值力矩降低。
对照组参与者比膝关节骨关节炎患者年轻约 10 岁。尽管存在这种差异,但各组之间的体重指数和步速均无差异,而这两个因素对步态力学的影响更强。
膝关节外侧骨关节炎患者的膝关节和后足额状面步态力学与膝关节内侧骨关节炎患者不同。本研究的结果可能有助于针对治疗膝关节外侧骨关节炎患者的干预措施的发展。