Diamond Laura E, Wrigley Tim V, Bennell Kim L, Hinman Rana S, O'Donnell John, Hodges Paul W
The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, 161 Barry Street, Parkville, VIC 3010, Australia.
The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, 161 Barry Street, Parkville, VIC 3010, Australia.
Gait Posture. 2016 Jan;43:198-203. doi: 10.1016/j.gaitpost.2015.09.023. Epub 2015 Oct 9.
Femoroacetabular impingement (FAI) is a morphological hip condition that can cause hip/groin pain and impaired function in younger active adults, and may lead to stiffness, muscle weakness, structural damage, and hip osteoarthritis. Understanding the impairments associated with FAI is crucial to guide treatment and rehabilitation strategies. Evidence is limited and conflicting about whether hip biomechanics are impaired during walking in people with symptomatic FAI. The objective of this study was to determine whether kinematics and kinetics during gait differ between people with symptomatic FAI and control participants. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery and 14 age-, and sex-matched disease-free controls underwent three-dimensional gait analysis. Tri-planar hip kinematics and kinetics were compared between the two groups. There were limited significant between-group differences with respect to spatiotemporal variables. Participants with FAI walked with less range of motion in the sagittal plane during a gait cycle, but did not exhibit any significant kinematic differences in the frontal or transverse planes. There were no systematic differences in kinetics between the groups in any plane. Findings suggest that individuals with symptomatic FAI have minimal impairments in gait biomechanics. Although these individuals demonstrate reduced hip joint motion in the sagittal plane, the size of the difference is small and its significance for symptoms and function is unclear. More pronounced deficits in hip kinetics and kinematics may be evident during functional tasks that challenge the hip towards the position of impingement.
股骨髋臼撞击症（FAI）是一种髋关节形态学疾病，可导致年轻活跃成年人出现髋部/腹股沟疼痛及功能受损，并可能引发关节僵硬、肌肉无力、结构损伤和髋骨关节炎。了解与FAI相关的功能障碍对于指导治疗和康复策略至关重要。关于有症状的FAI患者在行走过程中髋关节生物力学是否受损，证据有限且存在矛盾。本研究的目的是确定有症状的FAI患者与对照参与者在步态过程中的运动学和动力学是否存在差异。15名被诊断为有症状的凸轮型或复合型（凸轮加钳夹型）FAI且计划接受关节镜手术的参与者，以及14名年龄和性别匹配的无病对照者接受了三维步态分析。比较了两组之间的三平面髋关节运动学和动力学。在时空变量方面，组间差异有限。FAI患者在步态周期中矢状面的运动范围较小，但在额状面或横断面未表现出任何显著的运动学差异。两组在任何平面的动力学均无系统性差异。研究结果表明，有症状的FAI患者在步态生物力学方面的功能障碍极小。尽管这些个体在矢状面的髋关节运动减少，但其差异大小较小，对症状和功能的意义尚不清楚。在使髋关节向撞击位置移动的功能性任务中，可能会更明显地出现髋关节动力学和运动学方面的缺陷。
