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力线鞋对膝骨关节炎患者步态模式的影响。

Influence of the instrumented force shoe on gait pattern in patients with osteoarthritis of the knee.

机构信息

Department of Rehabilitation Medicine, Research Institute MOVE, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.

出版信息

Med Biol Eng Comput. 2011 Dec;49(12):1381-92. doi: 10.1007/s11517-011-0818-z. Epub 2011 Aug 25.

Abstract

Osteoarthritis (OA) of the knee is associated with alterations in gait. As an alternative to force plates, instrumented force shoes (IFSs) can be used to measure ground reaction forces. This study evaluated the influence of IFS on gait pattern in patients with knee OA. Twenty patients with knee OA walked in a gait laboratory on IFS and control shoes (CSs). An optoelectronic system and force plate were used to perform 3D gait analyses. A comparison of temporal-spatial gait parameters, kinematics, and kinetics was made between IFS and CS. Patients wearing IFS showed a decrease in walking velocity and cadence (8%), unchanged stride length, an increase in stance time (13%), stride time (11%) and step width (14%). No differences were found in knee adduction moment or knee kinematics. Small differences were found in foot and ankle kinematics (2-5°), knee transverse moments (5%), ankle frontal (3%) and sagittal moments (1%) and ground reaction force (1-6%). The gait of patients with knee OA was only mildly influenced by the IFS, due to increased shoe height and weight and a change in sole stiffness. The changes were small compared to normal variation and clinically relevant differences. Importantly, in OA patients no effect was found on the knee adduction moment.

摘要

膝关节骨关节炎(OA)与步态改变有关。与力板相比,仪器化力鞋(IFS)可用于测量地面反作用力。本研究评估了 IFS 对膝 OA 患者步态模式的影响。20 例膝 OA 患者在步态实验室中穿着 IFS 和对照鞋(CS)行走。使用光电系统和力板进行三维步态分析。比较了 IFS 和 CS 之间的时空步态参数、运动学和动力学。穿着 IFS 的患者步行速度和步频(8%)下降,步长不变,站立时间(13%)、步幅时间(11%)和步宽(14%)增加。膝关节内收力矩或膝关节运动学无差异。足部和踝关节运动学(2-5°)、膝关节横向力矩(5%)、踝关节额状面(3%)和矢状面力矩(1%)和地面反作用力(1-6%)有微小差异。由于鞋高和重量增加以及鞋底刚度的变化,膝 OA 患者的步态仅受到 IFS 的轻度影响。与正常变化和临床相关差异相比,这些变化很小。重要的是,在 OA 患者中,没有发现膝内收力矩的变化。

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