Nagano Yasuharu, Naito Kenji, Saho Yasuaki, Torii Suguru, Ogata Toru, Nakazawa Kimitaka, Akai Masami, Fukubayashi Toru
Niigata University of Health and Welfare, Department of Health and Sports, Niigata, Japan.
Knee. 2012 Oct;19(5):628-32. doi: 10.1016/j.knee.2011.11.002. Epub 2011 Dec 20.
Osteoarthritis patients may exhibit different kinematics according to the disease stage. However, changes in the frontal and horizontal planes in each stage remain unclear. The purpose of this study was to investigate changes in the knee kinematic gait variables of osteoarthritis patients, including the frontal and horizontal planes, with respect to the severity of the disease.
Forty-five patients with knee osteoarthritis and 13 healthy young subjects were recruited for the experiment. All subjects were examined while walking on a 10-m walkway at a self-selected speed. In each trial, we calculated the angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation. We also measured muscle strength, range of motion (ROM), and alignment. We compared the differences in osteoarthritis severity and knee kinematic variables between osteoarthritis patients and normal subjects.
The flexion angle at the time of foot contact was significantly less in patients with severe and moderate osteoarthritis than in normal subjects (both p<0.01). The abduction angle at the 50% stance phase was significantly less in patients with severe osteoarthritis than in normal subjects (p<0.05). The excursion of axial tibial rotation was significantly less in patients with early osteoarthritis than in normal subjects (p<0.05).
Osteoarthritis patients had different knee kinematics during gait, depending on the progress of osteoarthritis. Early-stage patients exhibit decreased axial tibial rotation excursion, while severe-stage patient exhibit increased knee adduction.
骨关节炎患者可能根据疾病阶段表现出不同的运动学特征。然而,每个阶段在额状面和水平面的变化仍不清楚。本研究的目的是调查骨关节炎患者膝关节运动步态变量的变化,包括额状面和水平面,与疾病严重程度的关系。
招募了45名膝关节骨关节炎患者和13名健康年轻受试者进行实验。所有受试者均以自选速度在10米的通道上行走时接受检查。在每次试验中,我们计算了屈伸、内收外展和胫骨内外旋转的角位移。我们还测量了肌肉力量、活动范围(ROM)和对线情况。我们比较了骨关节炎患者和正常受试者在骨关节炎严重程度和膝关节运动学变量方面的差异。
重度和中度骨关节炎患者在足接触时的屈曲角度明显小于正常受试者(均p<0.01)。重度骨关节炎患者在站立阶段50%时的外展角度明显小于正常受试者(p<0.05)。早期骨关节炎患者的胫骨轴向旋转偏移明显小于正常受试者(p<0.05)。
骨关节炎患者在步态期间膝关节运动学特征不同,这取决于骨关节炎的进展情况。早期患者表现出胫骨轴向旋转偏移减少,而重度患者表现出膝关节内收增加。