Komaris Dimitrios-Sokratis, Govind Cheral, Murphy Andrew, Ewen Alistair, Riches Philip
1 University of Strathclyde.
2 Golden Jubilee National Hospital.
J Appl Biomech. 2018 Apr 1;34(2):96-103. doi: 10.1123/jab.2016-0279. Epub 2018 Apr 6.
Patients with osteoarthritis of the knee commonly alter their movement to compensate for lower limb weakness and alleviate joint pain. Movement alterations may lead to weight-bearing asymmetries, and potentially to the progression of the disease. This study presents a novel numerical procedure for the identification of sit-to-walk strategies and differences in movement habits between control adults and persons with knee osteoarthritis. Ten control and 12 participants with osteoarthritis performed the sit-to-walk task in a motion capture laboratory. Participants sat on a stool with the height adjusted to 100% of their knee height, then stood and walked to pick up an object from a table in front of them. Different movement strategies were identified by means of hierarchical clustering. Trials were also classified as to whether the left and right extremities used a bilateral or an asymmetrical strategy. Participants with osteoarthritis used significantly more asymmetrical arm strategies (P = .03) while adopting the pushing through the chair strategy more often than the control subjects (P = .02). The results demonstrated that the 2 groups favor different sit-to-walk strategies. Asymmetrical arm behavior possibly indicates a compensation for the weakness of the affected leg. The proposed procedure may be useful to rapidly assess postoperative outcomes and developing rehabilitation strategies.
膝关节骨关节炎患者通常会改变其运动方式，以代偿下肢无力并减轻关节疼痛。运动改变可能导致负重不对称，并有可能导致疾病进展。本研究提出了一种新的数值方法，用于识别从坐到走的策略以及对照成年人与膝关节骨关节炎患者之间运动习惯的差异。10名对照者和12名骨关节炎参与者在运动捕捉实验室中完成了从坐到走的任务。参与者坐在高度调整为其膝关节高度100%的凳子上，然后起身走到他们面前桌子上拿起一个物体。通过层次聚类识别不同的运动策略。试验还根据左右肢体采用双侧还是不对称策略进行分类。骨关节炎参与者使用明显更多的不对称手臂策略（P = 0.03），同时比对照者更频繁地采用推椅子策略（P = 0.02）。结果表明，两组倾向于不同的从坐到走策略。不对称手臂行为可能表明对患侧腿部无力的代偿。所提出的方法可能有助于快速评估术后结果并制定康复策略。
