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临床评估的膝关节内外侧活动度:对步态的影响。

Clinically assessed mediolateral knee motion: impact on gait.

机构信息

Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Clin J Sport Med. 2011 Nov;21(6):515-20. doi: 10.1097/JSM.0b013e318230f6d8.

Abstract

OBJECTIVE

Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigate if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position.

DESIGN

Participants were visually assessed during a single-limb mini squat test and classified by a physiotherapist as exhibiting either a knee-medial-to-foot or knee-over-foot position. A comparison of 3-dimensional hip and knee gait kinematics and kinetics between the knee-over-foot and knee-medial-to-foot classifications was performed.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-five healthy participants were recruited and visually assessed as either knee-over-foot (n = 15; 26.2 ± 6.1 years) or knee-medial-to-foot (n = 10; 24.8 ± 4.1 years).

MAIN OUTCOME MEASURES

Peak knee valgus angle and peak internal hip rotation during normal gait.

RESULTS

No differences were observed in peak knee valgus angle [3.6 (3.7) vs 5.2 (2.5) degrees; P = 0.19], peak internal hip rotation [8.4 (7.0) vs 4.3 (8.1) degrees; P = 0.21], or knee joint kinetics between groups.

CONCLUSIONS

A knee-medial-to-foot position observed during the single-limb mini squat was not reflected during gait measured by 3-dimensional motion analysis in knee healthy individuals. Furthermore, those assessed to have a knee-medial-to-foot position did not display increased loading of the knee joint compared with the knee-over-foot group. Care should be taken when extrapolating results from one movement to another.

摘要

目的

通过临床测试可以对膝关节内外侧活动进行直观评估。膝关节向脚的内侧位置与膝关节损伤和病变的风险增加有关。然而,这些发现对日常活动的影响尚不清楚。本研究旨在探讨在临床测试中评估的膝关节向脚的内侧位置与膝关节过伸位置相比,是否与步态时髋关节和膝关节运动学以及膝关节动力学的改变有关。

设计

在单腿微蹲测试中对参与者进行直观评估,并由理疗师将其分为膝关节向脚的内侧位置或膝关节过伸位置。比较了膝关节过伸和膝关节向脚的内侧位置的 3 维髋关节和膝关节运动学以及动力学。

地点

研究实验室。

参与者

招募了 25 名健康参与者,并根据视觉评估将其分为膝关节过伸组(n=15;26.2±6.1 岁)或膝关节向脚的内侧位置组(n=10;24.8±4.1 岁)。

主要观察指标

正常步态时的最大膝关节外翻角度和最大髋关节内旋角度。

结果

两组间最大膝关节外翻角度[3.6(3.7)°比 5.2(2.5)°;P=0.19]、最大髋关节内旋角度[8.4(7.0)°比 4.3(8.1)°;P=0.21]或膝关节动力学无差异。

结论

在单腿微蹲中观察到的膝关节向脚的内侧位置在 3 维运动分析测量的膝关节健康个体的步态中并未反映出来。此外,与膝关节过伸组相比,评估为膝关节向脚的内侧位置的患者膝关节受力并未增加。在将一个动作的结果推断到另一个动作时应谨慎。

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