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髋关节骨关节炎患者步态中与动态运动相关的被动髋关节活动度测量

Passive hip movement measurements related to dynamic motion during gait in hip osteoarthritis.

作者信息

Baker Matt, Moreside Janice, Wong Ivan, Rutherford Derek J

机构信息

Faculty of Health Professions, School of Physiotherapy, Dalhousie University, 4th Floor Forrest Building, 5869 University Ave, 15000, Halifax, Nova Scotia, Canada.

Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

J Orthop Res. 2016 Oct;34(10):1790-1797. doi: 10.1002/jor.23198. Epub 2016 Mar 3.

Abstract

Reduced sagittal plane range of motion (ROM) has been reported in individuals with hip osteoarthritis (OA) both during walking and passive testing. The purpose of this study was to determine if a relationship exists between hip extension ROM recorded during gait and passive hip extension ROM in individuals with moderate and severe hip OA, in comparison to an asymptomatic group. Sagittal plane hip ROM was calculated using skin surface marker trajectories captured during treadmill walking at self-selected speed. Passive hip ROM was measured using standardized position and recording procedures with a goniometer. Sagittal plane extension, flexion, and overall ROM were measured dynamically and passively. A two-way mixed model analysis of variance determined significant differences between groups and between passive and dynamic ROM (α = 0.05). Pearson correlations determined relationships between passive and dynamic ROM. Significant group by ROM interactions were found for flexion and extension ROM (p < 0.05). For extension, the severe OA group had less dynamic and passive ROM compared to the other groups and greater passive than dynamic ROM (p < 0.05). For flexion, significant differences in passive ROM existed between all three groups (p < 0.05) whereas no differences were found for dynamic flexion (p < 0.05). Significant correlations between dynamic and passive hip extension were found in the moderate (r = 0.596) and severe OA (r = 0.586) groups, and no correlation was found in the asymptomatic group (r = 0.139). Passive ROM explains variance in dynamic ROM measurements obtained during gait in individuals with moderate and severe hip OA which have implications for the design of treatment strategies targeting walking pathomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1790-1797, 2016.

摘要

据报道,髋关节骨关节炎(OA)患者在行走和被动测试过程中矢状面活动度(ROM)均降低。本研究的目的是确定与无症状组相比,中重度髋关节OA患者在步态中记录的髋关节伸展ROM与被动髋关节伸展ROM之间是否存在关联。使用在跑步机上以自选速度行走时捕获的皮肤表面标记轨迹计算矢状面髋关节ROM。使用角度计通过标准化位置和记录程序测量被动髋关节ROM。动态和被动测量矢状面伸展、屈曲和总体ROM。双向混合方差分析确定了组间以及被动和动态ROM之间的显著差异(α = 0.05)。Pearson相关性确定了被动和动态ROM之间的关系。发现屈曲和伸展ROM存在显著的组×ROM交互作用(p < 0.05)。对于伸展,重度OA组与其他组相比,动态和被动ROM均较小,且被动ROM大于动态ROM(p < 0.05)。对于屈曲,所有三组之间被动ROM存在显著差异(p < 0.05),而动态屈曲未发现差异(p < 0.05)。在中度(r = 0.596)和重度OA(r = 0.586)组中发现动态和被动髋关节伸展之间存在显著相关性,而在无症状组中未发现相关性(r = 0.139)。被动ROM解释了中重度髋关节OA患者在步态中获得的动态ROM测量值的差异,这对针对行走病理力学的治疗策略设计具有重要意义。© 2016骨科研究协会。由Wiley Periodicals, Inc.出版。《矫形外科学研究》34:1790 - 1797, 2016。

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