Arnold John, Mackintosh Shylie, Jones Sara, Thewlis Dominic
Biomechanics and Neuromotor Laboratory, Exercise for Health and Human Performance Research Group, School of Health Sciences, University of South Australia, Adelaide, Australia.
Sansom Institute for Health Research, University of South Australia, Adelaide, Australia; International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, Australia.
Knee. 2014 Dec;21(6):1101-6. doi: 10.1016/j.knee.2014.08.004. Epub 2014 Sep 4.
Footwear and insoles are used to reduce knee load in people with medial knee osteoarthritis (OA), despite a limited understanding of foot function in this group. The aim of this study was to investigate the differences in foot kinematics between adults with and without medial knee OA during barefoot walking.
Foot kinematics were measured during walking in 30 adults; 15 with medial knee OA (mean age was 67.0 with a standard deviation (SD) of 8.9 years; height was 1.66 with SD of 0.13 m; body mass was 84.2 with SD of 15.8 kg; BMI was 30.7 with SD of 6.2 kg/m(2); K-L grade 3: 5, grade 4: 10) and 15 aged and gender matched control participants with 12 motion analysis cameras using the IOR multi-segment foot model. Motion of the knee joint, hindfoot, midfoot, forefoot and hallux were compared between groups using clustered linear regression.
The knee OA group displayed reduced coronal plane range of motion of the midfoot (mean 3.8° vs. 5.4°, effect size=1.1, p=0.023), indicating reduced midfoot mobility. There was also a reduced sagittal plane range of motion at the hallux in the knee OA group compared to the control group (mean 29.6° vs. 36.3°, effect size=1.2, p=0.008). No statistically significant differences in hindfoot or forefoot motion were observed.
People with medial knee OA display altered foot function compared to healthy controls. As foot and knee function are related, it is possible that altered foot function in people with knee OA may influence the effects of footwear and insoles.
尽管对内侧膝关节骨关节炎(OA)患者的足部功能了解有限,但鞋类和鞋垫仍被用于减轻该群体的膝关节负荷。本研究的目的是调查内侧膝关节OA患者与非OA成年人在赤足行走时足部运动学的差异。
对30名成年人行走时的足部运动学进行测量;15名内侧膝关节OA患者(平均年龄67.0岁,标准差(SD)8.9岁;身高1.66米,SD 0.13米;体重84.2千克,SD 15.8千克;BMI 30.7,SD 6.2千克/米²;K-L分级3级:5例,4级:10例)和15名年龄及性别匹配的对照参与者,使用12台运动分析摄像机和IOR多节段足部模型。采用聚类线性回归比较两组之间膝关节、后足、中足、前足和拇趾的运动情况。
膝关节OA组中足在冠状面的活动范围减小(平均3.8°对5.4°,效应大小=1.1,p=0.023),表明中足活动度降低。与对照组相比,膝关节OA组拇趾在矢状面的活动范围也减小(平均29.6°对36.3°,效应大小=1.2,p=0.008)。后足或前足运动未观察到统计学显著差异。
与健康对照相比,内侧膝关节OA患者的足部功能发生改变。由于足部和膝关节功能相关,膝关节OA患者足部功能的改变可能会影响鞋类和鞋垫的效果。