Foucher Kharma C
Department of Kinesiology and Nutrition, University of Illinois at Chicago, USA.
Clin Biomech (Bristol). 2017 Oct;48:24-29. doi: 10.1016/j.clinbiomech.2017.07.002. Epub 2017 Jul 4.
Hip osteoarthritis results in abnormal gait mechanics, but it is not known whether abnormalities are the same in men and women. The hypothesis tested was that gait abnormalities are different in men and women with hip osteoarthritis vs. sex-specific asymptomatic groups.
150 subjects with mild through severe radiographic hip osteoarthritis and 159 asymptomatic subjects were identified from an Institutional Review Board-approved motion analysis data repository. Sagittal plane hip range of motion and peak external moments about the hip, in all three planes, averaged from normal speed walking trials, were compared for men and women, with and without hip osteoarthritis using analysis of variance.
There were significant sex by group interactions for the external peak hip adduction and external rotation moments (P=0.009-0.045). Although asymptomatic women had peak adduction and external rotation moments that were respectively 12% higher and 23% lower than asymptomatic men (P=0.026-0.037), these variables did not differ between men and women with hip osteoarthritis (P≥0.684). The osteoarthritis vs. asymptomatic group difference in the peak hip adduction moment was 45% larger in women than in men. The osteoarthritis vs. asymptomatic group difference in the peak hip external rotation moment was 55% larger for men than for women (P<0.001). Sex did not influence the association between radiographic severity and gait variables.
Normal sex differences in gait were not seen in hip osteoarthritis. Sex-specific adaptations may reflect different aspects of hip abductor function. Men and women with hip osteoarthritis may require different interventions to improve function.
髋关节骨关节炎会导致异常的步态力学，但尚不清楚男性和女性的异常情况是否相同。所检验的假设是，与性别特异性无症状组相比，患有髋关节骨关节炎的男性和女性的步态异常情况不同。
从一个经机构审查委员会批准的运动分析数据存储库中识别出150名患有轻度至重度影像学髋关节骨关节炎的受试者和159名无症状受试者。使用方差分析比较了患有和未患有髋关节骨关节炎的男性和女性在正常速度行走试验中平均得出的矢状面髋关节活动范围以及髋关节在所有三个平面上的最大外部力矩。
在髋关节最大内收和外旋力矩方面，存在显著的性别与分组交互作用（P = 0.009 - 0.045）。尽管无症状女性的最大内收和外旋力矩分别比无症状男性高12%和低23%（P = 0.026 - 0.037），但这些变量在患有髋关节骨关节炎的男性和女性之间并无差异（P≥0.684）。患有骨关节炎的女性与无症状组相比，髋关节最大内收力矩的差异比男性大45%。患有骨关节炎的男性与无症状组相比，髋关节最大外旋力矩的差异比女性大55%（P<0.001）。性别并未影响影像学严重程度与步态变量之间的关联。
在髋关节骨关节炎中未观察到正常的步态性别差异。性别特异性适应可能反映了髋关节外展肌功能的不同方面。患有髋关节骨关节炎的男性和女性可能需要不同的干预措施来改善功能。
