Rosenlund Signe, Holsgaard-Larsen Anders, Overgaard Søren, Jensen Carsten
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.
Department of Orthopaedic Surgery and Traumatology, Køge Hospital, Køge, Denmark.
PLoS One. 2016 Apr 11;11(4):e0153177. doi: 10.1371/journal.pone.0153177. eCollection 2016.
The Gait Deviation Index summarizes overall gait 'quality', based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis.
Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL).
Mean Gait Deviation Index was positively associated with hip abduction strength (p<0.01, r = 0.40), hip flexion strength (p = 0.01, r = 0.37), HOOS-Physical Function (p<0.01, r = 0.41) HOOS-QOL (p<0.01, r = 0.41), and negatively associated with HOOS-Pain after walking (p<0.01, r = -0.45). Adjusting the analysis for walking speed did not affect the association.
Patients with the strongest hip abductor and hip flexor muscles had the best gait 'quality'. Furthermore, patients with higher physical function, quality of life scores and lower pain levels demonstrated better gait 'quality'. These findings indicate that interventions aimed at improving hip muscle strength and pain management may to a moderate degree improve the overall gait 'quality' in patients with primary hip OA.
步态偏差指数基于三维步态分析的运动学数据总结整体步态“质量”。然而，尚不清楚哪些临床结果可能影响原发性髋骨关节炎患者的步态偏差指数。本研究的目的是调查作为步态“质量”指标的步态偏差指数与髋部肌肉力量之间以及步态偏差指数与原发性髋骨关节炎患者自我报告结果之间的关联。
47例患者（34例男性），年龄61.1±6.7岁，体重指数27.3±3.4（kg/m²），患有严重原发性髋骨关节炎，接受了三维步态分析。记录平均步态偏差指数、行走后疼痛以及最大等长髋部肌肉力量（屈肌、伸肌和外展肌）。所有患者均完成了“髋部残疾和骨关节炎结果评分身体功能简表（HOOS-身体功能）”以及髋部残疾和骨关节炎结果评分疼痛（HOOS-疼痛）和生活质量（HOOS-生活质量）子量表。
平均步态偏差指数与髋外展力量（p<0.01，r = 0.40）、髋屈曲力量（p = 0.01，r = 0.37）、HOOS-身体功能（p<0.01，r = 0.41）、HOOS-生活质量（p<0.01，r = 0.41）呈正相关，与行走后HOOS-疼痛呈负相关（p<0.01，r = -0.45）。对步行速度进行分析调整并不影响这种关联。
髋外展肌和髋屈肌最强的患者步态“质量”最佳。此外，身体功能、生活质量评分较高且疼痛水平较低的患者步态“质量”更好。这些发现表明，旨在改善髋部肌肉力量和疼痛管理的干预措施可能在一定程度上改善原发性髋骨关节炎患者的整体步态“质量”。
