股骨髋臼撞击症患者从坐到站过程中的异常关节力矩分布及功能表现
Abnormal Joint Moment Distributions and Functional Performance During Sit-to-Stand in Femoroacetabular Impingement Patients.
作者信息
Samaan Michael A, Schwaiger Benedikt J, Gallo Matthew C, Link Thomas M, Zhang Alan L, Majumdar Sharmila, Souza Richard B
机构信息
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California-San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94107(∗).
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA(†).
出版信息
PM R. 2017 Jun;9(6):563-570. doi: 10.1016/j.pmrj.2016.10.002. Epub 2016 Oct 8.
BACKGROUND
Femoroacetabular impingement (FAI) is a morphological abnormality of the hip joint that causes pain when performing a mechanically demanding activity of daily living such as the sit-to-stand (STS) task. Previous studies have assessed lower extremity joint mechanics during an STS task in various pathologies, yet the STS task has not been studied in FAI patients.
OBJECTIVE
The objective of this study was to identify differences in joint kinetics and performance between FAI patients and healthy controls during a STS task. It was hypothesized that FAI patients would exhibit altered time needed to complete the STS task, as well as altered lower extremity biomechanics, when compared to healthy controls.
DESIGN
This was a cross-sectional cohort study.
SETTING
The study took place at a motion capture laboratory at an institutional orthopedic facility.
PARTICIPANTS
Biomechanical analysis was performed in 17 FAI patients and 31 age- and body mass index (BMI)-matched healthy controls during the STS task.
METHODS
Sagittal plane joint moments, total support moment (TSM), joint contributions to the TSM, and functional measures during the STS task were compared between groups.
MAIN OUTCOME MEASUREMENTS
Peak joint moments, TSM and joint contributions to the TSM were assessed during the STS task. In addition, the time to and value of the peak vertical ground reaction force (vGRF), limb symmetry index at peak vGRF, loading rate, and total time needed to perform the STS task were determined.
RESULTS
Compared to the control participants, the FAI patients exhibited worse Hip Disability and Osteoarthritis Outcome Score (HOOS) pain and function subscores. No group differences were observed in peak sagittal joint moments during the STS task. However, when compared to controls, the FAI patients demonstrated reduced knee joint contributions to the TSM. In addition, the FAI patients exhibited increased time needed to perform the STS task, increased time to reach peak vGRF, and reduced lower extremity loading rate during the STS task.
CONCLUSIONS
FAI patients demonstrated abnormal joint contributions to TSM and altered functional performance during the STS task. These altered movement patterns during the STS task may be compensatory mechanisms used by the FAI patients to reduce pain and to improve function.
LEVEL OF EVIDENCE
Not applicable.
背景
股骨髋臼撞击症（FAI）是一种髋关节形态异常，在进行诸如从坐到站（STS）任务等对机械要求较高的日常生活活动时会引起疼痛。以往的研究评估了各种病理情况下STS任务期间的下肢关节力学，但尚未对FAI患者进行过STS任务的研究。
目的
本研究的目的是确定FAI患者与健康对照组在STS任务期间关节动力学和表现的差异。研究假设是，与健康对照组相比，FAI患者完成STS任务所需的时间会改变，下肢生物力学也会改变。
设计
这是一项横断面队列研究。
地点
该研究在一家机构骨科设施的运动捕捉实验室进行。
参与者
在STS任务期间，对17名FAI患者和31名年龄及体重指数（BMI）匹配的健康对照组进行了生物力学分析。
方法
比较了两组在矢状面关节力矩、总支撑力矩（TSM）、关节对TSM的贡献以及STS任务期间的功能指标。
主要观察指标
在STS任务期间评估峰值关节力矩、TSM和关节对TSM的贡献。此外，还确定了峰值垂直地面反作用力（vGRF）出现的时间和值、峰值vGRF时的肢体对称指数、加载速率以及完成STS任务所需的总时间。
结果
与对照组参与者相比，FAI患者的髋关节残疾和骨关节炎结果评分（HOOS）疼痛和功能子评分更差。在STS任务期间，矢状面峰值关节力矩未观察到组间差异。然而，与对照组相比，FAI患者膝关节对TSM的贡献减少。此外，FAI患者完成STS任务所需的时间增加，达到峰值vGRF的时间增加，并且在STS任务期间下肢加载速率降低。
结论
FAI患者在STS任务期间表现出对TSM的关节贡献异常和功能表现改变。这些在STS任务期间改变的运动模式可能是FAI患者用来减轻疼痛和改善功能的代偿机制。
证据水平
不适用。
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