Mahmoudian Armaghan, van Dieёn Jaap H, Baert Isabel A C, Bruijn Sjoerd M, Faber Gert S, Luyten Frank P, Verschueren Sabine M P
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium.
MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands.
Clin Biomech (Bristol). 2017 Dec;50:32-39. doi: 10.1016/j.clinbiomech.2017.10.004. Epub 2017 Oct 2.
Despite the large number of cross-sectional studies on gait in subjects with knee osteoarthritis, there are scarcely any longitudinal studies on gait changes in knee osteoarthritis.
Gait analysis was performed on 25 women with early and 18 with established medial knee osteoarthritis, as well as a group of 23 healthy controls. Subjects were asked to walk at their comfortable speed. Kinematic and kinetic data were measured at baseline and after 2years follow-up.
Results indicated that the early osteoarthritis group, similar to established osteoarthritis group, showed significantly higher maximum knee adduction angles compared to the controls during the early stance phase of gait. None of the kinematic or kinetic measures, changed over two years in the early osteoarthritis group. In the established osteoarthritis group, at the time of entry, an increased first and second peak knee adduction moment, as well as higher mid-stance knee adduction moment and knee adduction moment impulse, were present compared to the control and the early osteoarthritis groups. Mid-stance knee adduction moment and knee adduction moment impulse, further increased over two years only in the established osteoarthritis group. For all three groups, the peak knee flexion angle during the stance phase decreased significantly over time.
Increased maximum knee adduction angle during stance phase was the only alteration in the gait pattern of subjects with early knee osteoarthritis compared to the controls. This suggests that, unlike in the later stages of the disease, gait is rather stable over two years in early osteoarthritis.
尽管有大量关于膝关节骨关节炎患者步态的横断面研究,但几乎没有关于膝关节骨关节炎步态变化的纵向研究。
对25名早期膝关节内侧骨关节炎女性、18名已确诊膝关节内侧骨关节炎女性以及23名健康对照者进行步态分析。要求受试者以舒适的速度行走。在基线和2年随访后测量运动学和动力学数据。
结果表明,与对照组相比,早期骨关节炎组在步态的早期站立阶段,最大膝关节内收角显著更高,这与已确诊骨关节炎组相似。早期骨关节炎组的运动学或动力学指标在两年内均未发生变化。在已确诊骨关节炎组中,与对照组和早期骨关节炎组相比,在入组时,第一和第二峰值膝关节内收力矩增加,以及更高的站立中期膝关节内收力矩和膝关节内收力矩冲量也存在。仅在已确诊骨关节炎组中,站立中期膝关节内收力矩和膝关节内收力矩冲量在两年内进一步增加。对于所有三组,站立阶段的峰值膝关节屈曲角度随时间显著降低。
与对照组相比,早期膝关节骨关节炎患者步态模式中唯一的改变是站立阶段最大膝关节内收角增加。这表明,与疾病后期不同,早期骨关节炎患者的步态在两年内相当稳定。