Solomonow-Avnon Deborah, Herman Amir, Levin Daniel, Rozen Nimrod, Peled Eli, Wolf Alon
Faculty of Mechanical Engineering, Biorobotics and Biomechanics Lab (BRML), Technion-Israel Institute of Technology, Haifa 32000, Israel.
Department of Orthopedic Surgery A, Chaim Sheba Medical Center, Ramat-Gan, Israel.
J Orthop Res. 2017 Oct;35(10):2222-2232. doi: 10.1002/jor.23511. Epub 2017 Jan 18.
Footwear-generated biomechanical manipulation of lower-limb joints was shown to beneficially impact gait and quality of life in knee osteoarthritis patients, but has not been tested in hip osteoarthritis patients. We examined a customized gait treatment program using a biomechanical device shown in previous investigations to be capable of manipulating hip biomechanics via foot center of pressure (COP) modulation. The objective of this study was to assess the treatment program for hip osteoarthritis patients, enrolled in a 1-year prospective investigation, by means of objective gait and spatiotemporal parameters, and subjective quality of life measures. Gait analysis and completion of questionnaires were performed at the start of the treatment (baseline), and after 3, 6, and 12 months. Outcome parameters were evaluated over time using linear mixed effects models, and association between improvement in quality of life measures and change in objective outcomes was tested using mixed effect linear regression models. Quality of life measures improved compared to baseline, accompanied by increased gait speed and cadence. Sagittal-plane hip joint kinetics, kinematics, and spatiotemporal parameters changed throughout the study compared to baseline, in a manner suggesting improvement of gait. The most substantial improvement occurred within 3 months after treatment initiation, after which improvement approximately plateaued, but was sustained at 12 months. Speed and cadence, as well as several sagittal-plane gait parameters, were significant predictors of improvement in quality of life.
Evidence suggests that a biomechanical gait therapy program improves subjective and objective outcomes measures and is a valid treatment option for hip osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2222-2232, 2017.
研究表明，鞋类对下肢关节产生的生物力学操控对膝骨关节炎患者的步态和生活质量具有有益影响，但尚未在髋骨关节炎患者中进行测试。我们研究了一种定制的步态治疗方案，该方案使用了先前研究中显示能够通过足底压力中心（COP）调节来操控髋部生物力学的生物力学装置。本研究的目的是通过客观的步态和时空参数以及主观的生活质量测量方法，对参加为期1年的前瞻性研究的髋骨关节炎患者的治疗方案进行评估。在治疗开始时（基线）以及3、6和12个月后进行步态分析和问卷调查。使用线性混合效应模型对结果参数随时间进行评估，并使用混合效应线性回归模型测试生活质量测量指标的改善与客观结果变化之间的关联。与基线相比，生活质量测量指标有所改善，同时步态速度和步频增加。与基线相比，在整个研究过程中，矢状面髋关节动力学、运动学和时空参数发生了变化，表明步态有所改善。最显著的改善发生在治疗开始后的3个月内，此后改善大致趋于平稳，但在12个月时仍持续存在。速度、步频以及几个矢状面步态参数是生活质量改善的重要预测指标。
有证据表明，生物力学步态治疗方案可改善主观和客观结果测量指标，是髋骨关节炎的一种有效治疗选择。©2017骨科研究协会。由威利期刊公司出版。《矫形外科研究杂志》2017年第35卷：2222 - 2232页。
