Mannering N, Young T, Spelman T, Choong P F
The University of Melbourne, Melbourne Medical School, Melbourne, 3010 Victoria, Australia
Department of Orthopaedics, St. Vincent's Hospital, Melbourne, Level 3 Daly Wing, 35 Victoria Parade, Fitzroy, 3065 Victoria, Australia.
Bone Joint Res. 2017 Aug;6(8):514-521. doi: 10.1302/2046-3758.68.BJR-2016-0296.R1.
Whilst gait speed is variable between healthy and injured adults, the extent to which speed alone alters the 3D knee kinematics has not been fully described. The purpose of this prospective study was to understand better the spatiotemporal and 3D knee kinematic changes induced by slow compared with normal self-selected walking speeds within young healthy adults.
A total of 26 men and 25 women (18 to 35 years old) participated in this study. Participants walked on a treadmill with the KneeKG system at a slow imposed speed (2 km/hr) for three trials, then at a self-selected comfortable walking speed for another three trials. Paired -tests, Wilcoxon signed-rank tests, Mann-Whitney U tests and Spearman's rank correlation coefficients were conducted using Stata/IC 14 to compare kinematics of slow self-selected walking speed.
Both cadence and step length were reduced during slow gait compared with normal gait. Slow walking reduced flexion during standing (10.6° compared with 13.7°; p < 0.0001), and flexion range of movement (ROM) (53.1° compared with 57.3°; p < 0.0001). Slow walking also induced less adduction ROM (8.3° compared with 10.0°; p < 0.0001), rotation ROM (11.4 compared with 13.6; p < 0.0001), and anteroposterior translation ROM (8.5 mm compared with 10.1 mm; p < 0.0001).
The reduced spatiotemporal measures, reduced flexion during stance, and knee ROM in all planes induced by slow walking demonstrate a stiff knee gait, similar to that previously demonstrated in osteoarthritis. Further research is required to determine if these characteristics induced in healthy knees by slow walking provide a valid model of osteoarthritic gait.: N. Mannering, T. Young, T. Spelman, P. F. Choong. Three-dimensional knee kinematic analysis during treadmill gait: Slow imposed speed normal self-selected speed. 2017;6:514-521. DOI: 10.1302/2046-3758.68.BJR-2016-0296.R1.
虽然健康成年人与受伤成年人的步速有所不同，但仅速度变化对三维膝关节运动学的影响程度尚未得到充分描述。这项前瞻性研究的目的是更好地了解年轻健康成年人中，与正常自我选择的步行速度相比，缓慢步行所引起的时空和三维膝关节运动学变化。
共有26名男性和25名女性（18至35岁）参与了本研究。参与者在跑步机上使用KneeKG系统，以缓慢的强制速度（2公里/小时）行走三次，然后以自我选择的舒适步行速度再行走三次。使用Stata/IC 14进行配对检验、Wilcoxon符号秩检验、Mann-Whitney U检验和Spearman等级相关系数检验，以比较缓慢与自我选择步行速度下的运动学情况。
与正常步态相比，缓慢步态期间的步频和步长均降低。缓慢行走减少了站立时的膝关节屈曲角度（分别为10.6°和13.7°；p < 0.0001），以及运动范围（ROM）的屈曲角度（分别为53.1°和57.3°；p < 0.0001）。缓慢行走还导致内收ROM减少（分别为8.3°和10.0°；p < 0.0001）、旋转ROM减少（分别为11.4和13.6；p < 0.0001）以及前后平移ROM减少（分别为8.5毫米和10.1毫米；p < 0.0001）。
缓慢行走导致时空参数降低、站立时屈曲减少以及所有平面的膝关节ROM减少，表现出僵硬的膝关节步态，类似于先前在骨关节炎中所证明的情况。需要进一步研究以确定缓慢行走在健康膝关节中所诱导的这些特征是否能提供一个有效的骨关节炎步态模型。：N. Mannering、T. Young、T. Spelman、P. F. Choong。跑步机步态期间的三维膝关节运动学分析：缓慢强制速度与正常自我选择速度。2017；6：514 - 521。DOI：10.1302/2046 - 3758.68.BJR - 2016 - 0296.R1。
