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不对称性踝关节骨关节炎患者的步态模式

Gait patterns of asymmetric ankle osteoarthritis patients.

作者信息

Nüesch Corina, Valderrabano Victor, Huber Cora, von Tscharner Vinzenz, Pagenstert Geert

机构信息

Orthopaedic Department, University Hospital, University of Basel, Switzerland; Laboratory of Biomechanics & Biocalorimetry, University of Basel, Switzerland.

出版信息

Clin Biomech (Bristol). 2012 Jul;27(6):613-8. doi: 10.1016/j.clinbiomech.2011.12.016. Epub 2012 Jan 18.

Abstract

BACKGROUND

In early stages, ankle osteoarthritis is often asymmetric with only partially degenerated joint surfaces. There is only limited knowledge on the effect of asymmetric ankle osteoarthritis on the patients' gait patterns. Therefore, the aim of this study was to characterize kinematic and kinetic changes compared to healthy adults.

METHODS

Instrumented gait analysis was performed in eight asymmetric ankle osteoarthritis patients and 15 healthy controls. Beside conventional gait analysis methods, principal component analysis was used to analyze temporal progression of the most important variables: hindfoot dorsiflexion angle and vertical ground reaction force.

FINDINGS

Asymmetric ankle osteoarthritis patients had a lower hindfoot dorsiflexion and rotation range of motion as well as reduced peak ground reaction forces and peak kinetic values. Principal component analysis revealed that for both the hindfoot dorsiflexion angle and the vertical ground reaction force those principal component vectors affecting the amplitudes had significantly lower principal component scores in patients than in controls. The use of the principal component scores for classification with a linear support vector machine resulted in a high recognition rate of 97.8% for the discrimination between the affected leg and the healthy controls.

INTERPRETATION

Patients with asymmetric ankle osteoarthritis suffer from substantial pathological kinematic and kinetic gait changes. Principal component analysis combined with a linear support vector machine could successfully be used to temporally quantify and classify asymmetric ankle osteoarthritis gait patterns. This study therefore helps to understand the pathomechanism of early stage ankle osteoarthritis from a biomechanical view.

摘要

背景

在早期阶段,踝关节骨关节炎通常是不对称的,关节面仅有部分退变。关于不对称性踝关节骨关节炎对患者步态模式的影响,目前了解有限。因此,本研究的目的是描述与健康成年人相比的运动学和动力学变化。

方法

对8例不对称性踝关节骨关节炎患者和15名健康对照者进行了仪器化步态分析。除了传统的步态分析方法外,还使用主成分分析来分析最重要变量的时间进程:后足背屈角度和垂直地面反作用力。

结果

不对称性踝关节骨关节炎患者的后足背屈和旋转运动范围较小,地面反作用力峰值和动力学峰值降低。主成分分析显示,对于后足背屈角度和垂直地面反作用力,影响幅度的主成分向量在患者中的主成分得分显著低于对照组。使用主成分得分通过线性支持向量机进行分类,患侧腿与健康对照之间的辨别识别率高达97.8%。

解读

不对称性踝关节骨关节炎患者存在明显的病理性运动学和动力学步态变化。主成分分析结合线性支持向量机可成功用于对不对称性踝关节骨关节炎步态模式进行时间量化和分类。因此,本研究有助于从生物力学角度理解早期踝关节骨关节炎的发病机制。

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