Trinler Ursula K, Baty Florent, Mündermann Annegret, Fenner Verena, Behrend Henrik, Jost Bernhard, Wegener Regina
School of Health Science, University of Salford, Manchester, United Kingdom.
Division of Pulmonary Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
J Orthop Res. 2016 Oct;34(10):1753-1761. doi: 10.1002/jor.23181. Epub 2016 Jun 2.
Joint biomechanics during stair walking may contain important information on functional deficits in patients with orthopaedic conditions but depend on the stair dimension. The goal of this study was to compare knee kinematics and kinetics between patients with good outcome 2 years after total knee arthroplasty (TKA) and age-matched controls during stair ascent and descent at two different stair heights. Principal component analysis was used to detect differences in gait mechanics between 15 patients and 15 controls at different stair conditions. Linear mixed models showed differences in knee kinematic and kinetic patterns (in flexion/extension and abduction/adduction) between stair heights. The knee adduction angle was more affected by stair heights in stair ascending whereas knee adduction moment and knee power were more affected during stair descent. Some stair by height and subject effects were small but not significant. Overall, good outcome after TKA is reflected in close-to-normal knee biomechanics during stair walking. Specific stair configuration must be considered when comparing joint biomechanics between subject groups and studies. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1753-1761, 2016.
在上下楼梯过程中的关节生物力学可能包含有关骨科疾病患者功能缺陷的重要信息,但这取决于楼梯尺寸。本研究的目的是比较全膝关节置换术(TKA)两年后预后良好的患者与年龄匹配的对照组在两种不同楼梯高度下上下楼梯时的膝关节运动学和动力学。主成分分析用于检测15名患者和15名对照组在不同楼梯条件下的步态力学差异。线性混合模型显示不同楼梯高度之间膝关节运动学和动力学模式(屈伸和内收/外展)存在差异。在上楼梯时,楼梯高度对膝关节内收角度影响更大,而在下楼梯时,楼梯高度对膝关节内收力矩和膝关节功率影响更大。一些楼梯高度和个体效应较小但不显著。总体而言,TKA术后良好的预后体现在上下楼梯过程中接近正常的膝关节生物力学。在比较不同受试者组和研究之间的关节生物力学时,必须考虑特定的楼梯配置。©2016骨科研究协会。由Wiley Periodicals, Inc.出版。《矫形外科研究杂志》34:1753 - 1761, 2016年。