Delaware Rehabilitation Institute, University of Delaware,(1) 540 South College Ave, Newark, DE 19713, United States; Division of Rehabilitation Sciences, Department of Orthopedic Surgery & Rehabilitation, University of Texas Medical Branch-Galveston, 301 University Blvd. Route 0165, Rebecca Sealy 2.804, Galveston, TX 77555, United States.
School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219-3130, United States.
Gait Posture. 2018 Mar;61:439-444. doi: 10.1016/j.gaitpost.2018.01.025. Epub 2018 Feb 2.
Self-reported walking difficulty is a problem among patients with knee osteoarthritis (OA), however, these patients have never been studied as a subgroup population.
The purpose of this study is to examine known knee OA gait mechanics among those with knee OA, with (Diff) and without (NoDiff) self-reported walking difficulty, as compared to age- and sex-matched controls without knee OA.
A total of 39 subjects in three groups of 13 individuals walked at a controlled gait speed during instrumented gait analysis. Gait mechanics were compared between a priori determined groups using the independent t-test.
The results of the study found that among those with knee OA, knee excursion angles were not significantly different between the Diff and NoDiff groups. Whereas, external knee moments were significantly different between the Diff and NoDiff groups but not between the NoDiff and the control groups. The lack of difference between the NoDiff and control groups were especially interesting because of the moderate to severe OA in the NoDiff group. Therefore, the findings of this study suggest the importance of considering self-reported walking difficulty among those with knee OA. Perhaps patients with knee OA-related walking difficulties use alternative gait parameters that may need to be clinically addressed. Strengths of the study included a matched design and controlled walking speed, whereas limitations were the small sample size and cross-sectional design.
Given the relationships found among self-reported walking difficulty, OA presence, and gait parameters, addressing gait parameters specifically related to walking difficulty may be indicated in this sub-group knee OA population.
自我报告的行走困难是膝骨关节炎(OA)患者的一个问题,但这些患者从未作为亚组人群进行过研究。
本研究的目的是检查有(Diff)和无(NoDiff)自我报告行走困难的膝骨关节炎患者的已知膝骨关节炎步态力学,与无膝骨关节炎的年龄和性别匹配的对照组进行比较。
共有 39 名受试者分为三组,每组 13 人,在仪器步态分析中以控制的步态速度行走。使用独立 t 检验比较预先确定的组之间的步态力学。
研究结果发现,在膝骨关节炎患者中,Diff 组和 NoDiff 组的膝关节活动度无显著差异。然而,Diff 组和 NoDiff 组之间的膝关节外力矩有显著差异,但 NoDiff 组和对照组之间没有差异。NoDiff 组和对照组之间没有差异特别有趣,因为 NoDiff 组的 OA 为中度至重度。因此,本研究的结果表明,在膝骨关节炎患者中考虑自我报告的行走困难的重要性。也许与膝骨关节炎相关的行走困难的患者使用替代的步态参数,这些参数可能需要在临床上解决。本研究的优势包括匹配设计和控制的步行速度,而局限性是样本量小和横断面设计。
鉴于自我报告的行走困难、OA 存在和步态参数之间的关系,在这个亚组膝骨关节炎人群中,可能需要专门针对与行走困难相关的步态参数进行治疗。