* Institute of Biomedical Engineering, National Taiwan University, Taiwan, R.O.C.
‡ Department of Physical Therapy, Tzu-Hui Institute of Technology, Taiwan, R.O.C.
Am J Chin Med. 2017;45(1):23-35. doi: 10.1142/S0192415X17500033. Epub 2017 Jan 9.
Knee osteoarthritis (OA) often leads to altered balance control, joint motion and loading patterns during gait. Acupuncture has been proven to be effective in pain relief but its effects on inter-joint load-sharing for body balance have not been reported. The current study bridged the gap by quantifying the immediate effects of acupuncture on the inter-joint and inter-limb load-sharing in patients with knee OA during level walking in terms of the total support moment (Ms) and the contribution of individual joints to the total support moment. Gait analysis was performed on fifteen healthy controls and on fifteen patients with mild to moderate bilateral medial knee OA. After acupuncture treatment the patients with bilateral knee OA walked with significantly increased speed ([Formula: see text]), and were able to resist greater and closer-to-normal knee flexion moments ([Formula: see text]). They also changed the inter-joint sharing of the support moments with increased knee ([Formula: see text]) contributions, but reduced hip contributions ([Formula: see text]) to the sagittal Ms during single-limb support. They showed an asymmetric inter-limb load-sharing similar to the normal controls, with increased sharing of the time integral of both the sagittal and frontal whole body support moment by the leading limb during double-limb support ([Formula: see text]). The altered intra- and inter-limb contributions to the demand of supporting the body during gait suggests that acupuncture treatment led to immediate changes in the control strategy toward a normal pattern. However, the effects of these changes on the progression of the disease in the long term would require further investigation.
膝骨关节炎(OA)常导致步态中平衡控制、关节运动和加载模式改变。针灸已被证明对缓解疼痛有效,但它对身体平衡的关节间负荷分担的影响尚未报道。本研究通过定量分析膝骨关节炎患者在水平行走时针灸对膝关节 OA 患者关节间和肢体间负荷分担的即刻影响,填补了这一空白,具体指标为总支撑力矩(Ms)和各个关节对总支撑力矩的贡献。对 15 名健康对照者和 15 名轻度至中度双侧膝关节内侧 OA 患者进行了步态分析。双侧膝关节 OA 患者在接受针灸治疗后,行走速度明显加快([公式:见正文]),能够抵抗更大和更接近正常的膝关节屈曲力矩([公式:见正文])。他们还改变了关节间支撑力矩的分担,增加了膝关节([公式:见正文])的贡献,但减少了髋关节([公式:见正文])对单肢支撑矢状面 Ms 的贡献。他们表现出与正常对照相似的不对称肢体间负荷分担,在双肢支撑期间,主导肢体的矢状面和额状面整个身体支撑力矩的时间积分的分担增加([公式:见正文])。在步态中支撑身体需求的关节内和关节间贡献的改变表明,针灸治疗导致了对正常模式的即刻控制策略改变。然而,这些变化对疾病长期进展的影响需要进一步研究。