Paquette Max R, Zhang Songning, Milner Clare E, Klipple Gary
Health & Sport Science, University of Memphis, Memphis, TN, USA.
Kinesiology, Recreation and Sport Studies, University of Tennessee, Knoxville, TN, USA.
Knee. 2014 Jun;21(3):676-82. doi: 10.1016/j.knee.2014.02.020. Epub 2014 Mar 1.
Research shows that one of the first complaints from knee osteoarthritis (OA) patients is difficulty in stair ambulation due to knee pain. Increased step width (SW) has been shown to reduce first and second peak internal knee abduction moments, a surrogate variable for medial compartment knee joint loading, during stair descent in healthy older adults. This study investigates the effects of increased step width (SW) on knee biomechanics and knee pain in medial compartment knee OA patients during stair descent.
Thirteen medial compartment knee OA patients were recruited for the study. A motion analysis system was used to obtain three-dimensional joint kinematics. An instrumented staircase was used to collect ground reaction forces (GRF). Participants performed stair descent trials at their self-selected speed using preferred, wide, and wider SW. Participants rated their knee pain levels after each SW condition.
Increased SW had no effect on peak knee abduction moments and knee pain. Patients reported low levels of knee pain during all stair descent trials. The 2nd peak knee adduction angle and frontal plane GRF at time of 2nd peak abduction moment were reduced with increasing SW.
The findings suggest that increases in SW may not influence knee loads in medial compartment knee OA patients afflicted with low levels of knee pain during stair descent.
研究表明，膝关节骨关节炎（OA）患者最早出现的抱怨之一是由于膝关节疼痛而难以上下楼梯。研究显示，在健康老年人下楼梯时，增加步宽（SW）可减少首次和第二次膝关节内收峰值力矩，这是内侧间室膝关节负荷的一个替代变量。本研究调查了增加步宽（SW）对内侧间室膝关节OA患者下楼梯时膝关节生物力学和膝关节疼痛的影响。
招募了13名内侧间室膝关节OA患者参与本研究。使用运动分析系统获取三维关节运动学数据。使用装有仪器的楼梯收集地面反作用力（GRF）。参与者以自选速度，采用偏好步宽、宽步宽和更宽步宽进行下楼梯试验。参与者在每种步宽条件后对其膝关节疼痛程度进行评分。
增加步宽对膝关节内收峰值力矩和膝关节疼痛没有影响。患者在所有下楼梯试验中报告的膝关节疼痛程度较低。随着步宽增加，第二次膝关节内收峰值角度和第二次内收峰值力矩时的额面GRF降低。
研究结果表明，对于下楼梯时膝关节疼痛程度较低的内侧间室膝关节OA患者，增加步宽可能不会影响膝关节负荷。
