Bakouny Ziad, Assi Ayman, Massaad Abir, Saghbini Elie, Lafage Virginie, Skalli Wafa, Ghanem Ismat, Kreichati Gaby
Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon.
Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France.
Gait Posture. 2017 May;54:27-33. doi: 10.1016/j.gaitpost.2017.02.018. Epub 2017 Feb 22.
Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters. Subjects were divided according to Roussouly's sagittal alignment classification. Sagittal alignment and kinematic parameters were compared between Roussouly types. 17 subjects were classified as type 2, 47 as type 3, 26 as type 4 but only 1 as type 1. Type 2 subjects had significantly more mean pelvic retroversion (less mean pelvic tilt) during gait compared to type 3 and 4 subjects (type 2: 8.2°; type 3:11.2°, type 4: 11.3°) and significantly larger ROM pelvic obliquity compared to type 4 subjects (type 2: 11.0°; type 4: 9.1°). Type 2 subjects also had significantly larger maximal hip extension during stance compared to subjects of types 3 and 4 (type 2: -11.9°; type 3: -8.8°; type 4: -7.9°) and a larger ROM of ankle plantar/dorsiflexion compared to type 4 subjects (type 2: 31.1°; type 4: 27.9°). Subjects with type 2 sagittal alignment were shown to have a gait pattern involving both increased hip extension and pelvic retroversion which could predispose to posterior femoroacetabular impingement and consequently osteoarthritis.
矢状面排列在无症状成年受试者之间差异很大，这是已知的；然而，尚未有关于这些差异对步态可能产生影响的研究。本研究的目的是调查具有不同鲁索利矢状面排列形态型的无症状成年人是否有不同的行走方式。91名无症状的年轻成年人（46名男性和45名女性），年龄为21.6±2.2岁，接受了三维步态分析、全身双平面X射线检查，并对其脊柱和骨盆进行了三维重建，生成矢状面排列参数。受试者根据鲁索利的矢状面排列分类进行划分。比较了鲁索利类型之间的矢状面排列和运动学参数。17名受试者被归类为2型，47名被归类为3型，26名被归类为4型，但只有1名被归类为1型。与3型和4型受试者相比，2型受试者在步态中平均骨盆后倾明显更多（平均骨盆倾斜度更小）（2型：8.2°；3型：11.2°，4型：11.3°），与4型受试者相比，2型受试者骨盆倾斜度的活动范围明显更大（2型：11.0°；4型：9.1°）。与3型和4型受试者相比，2型受试者在站立期最大髋关节伸展也明显更大（2型：-11.9°；3型：-8.8°；4型：-7.9°），与4型受试者相比，2型受试者踝关节跖屈/背屈的活动范围更大（2型：31.1°；4型：27.9°）。结果显示，具有2型矢状面排列的受试者的步态模式包括髋关节伸展增加和骨盆后倾，这可能易导致股骨髋臼后撞击，进而导致骨关节炎。
