Burnett David R, Campbell-Kyureghyan Naira H, Topp Robert V, Quesada Peter M
Speed School of Engineering, University of Louisville, Louisville, KY 40292, USA.
College of Engineering and Applied Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
Biomed Res Int. 2015;2015:142562. doi: 10.1155/2015/142562. Epub 2015 Jun 11.
The effect of joint pathologies, such as unilateral knee osteoarthritis (UKOA) or low back pain (LBP), on bilateral gait symmetry has gained increased attention during the past decade. This study is the first to compare gait patterns between patients with UKOA and LBP in combination and with UKOA only. Temporal, kinematic, and kinetic variables were measured bilaterally during gait stance phase in 31 subjects with UKOA and LBP (Group I) and 11 subjects with only UKOA (Group II). Group I patients exhibited less hip rotation in the affected limb (A) than in the nonaffected (NA) limb during walking in contrast to Group II patients. Group I patients had minimal bilateral differences in hip abduction and flexion, but Group II patients displayed significantly larger values in the NA limb compared to the A limb for both parameters. Hip flexion patterns were significantly different between Groups I and II. Subjects in both groups adapted gait patterns that minimized vertical ground reaction force, knee flexion motion, and stance time on the UKOA affected limb. The distinct kinematic gait patterns that were revealed in this study may provide clinical value for assessment of patients with UKOA in conjunction with LBP.
在过去十年中,诸如单侧膝关节骨关节炎(UKOA)或腰痛(LBP)等关节病变对双侧步态对称性的影响受到了越来越多的关注。本研究首次比较了合并UKOA和LBP的患者与仅患有UKOA的患者之间的步态模式。在31例患有UKOA和LBP的受试者(I组)和11例仅患有UKOA的受试者(II组)的步态站立期,双侧测量了时间、运动学和动力学变量。与II组患者相比,I组患者在行走过程中患侧(A)髋关节的旋转幅度小于健侧(NA)。I组患者髋关节外展和屈曲的双侧差异最小,但II组患者这两个参数的健侧值均显著大于患侧。I组和II组之间的髋关节屈曲模式存在显著差异。两组受试者都采用了使垂直地面反作用力、膝关节屈曲运动以及UKOA患侧的站立时间最小化的步态模式。本研究中揭示的独特运动学步态模式可能为评估合并LBP的UKOA患者提供临床价值。