Suppr超能文献

膝关节骨关节炎和行走困难对膝关节运动学和动力学的影响。

Influences of knee osteoarthritis and walking difficulty on knee kinematics and kinetics.

机构信息

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.

出版信息

Gait Posture. 2018 Mar;61:439-444. doi: 10.1016/j.gaitpost.2018.01.025. Epub 2018 Feb 2.

Abstract

BACKGROUND

Self-reported walking difficulty is a problem among patients with knee osteoarthritis (OA), however, these patients have never been studied as a subgroup population.

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

目的

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。

方法

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。

结果

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。

结论

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。

相似文献

1
Influences of knee osteoarthritis and walking difficulty on knee kinematics and kinetics.
Gait Posture. 2018 Mar;61:439-444. doi: 10.1016/j.gaitpost.2018.01.025. Epub 2018 Feb 2.
2
Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics.
Gait Posture. 2015 Sep;42(3):373-9. doi: 10.1016/j.gaitpost.2015.07.005. Epub 2015 Jul 17.
3
Altered gait characteristics in individuals with knee osteoarthritis and self-reported knee instability.
J Orthop Sports Phys Ther. 2015 May;45(5):351-9. doi: 10.2519/jospt.2015.5540. Epub 2015 Mar 26.
4
Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.
Gait Posture. 2016 Jan;43:210-5. doi: 10.1016/j.gaitpost.2015.09.025. Epub 2015 Oct 8.
5
Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed.
J Biomech. 2007;40(8):1754-61. doi: 10.1016/j.jbiomech.2006.08.010. Epub 2006 Nov 7.
6
Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange.
Clin Orthop Relat Res. 2016 Sep;474(9):2055-63. doi: 10.1007/s11999-016-4921-1. Epub 2016 Jun 10.
7
Differences in gait parameters between healthy subjects and persons with moderate and severe knee osteoarthritis: a result of altered walking speed?
Clin Biomech (Bristol). 2009 May;24(4):372-8. doi: 10.1016/j.clinbiomech.2009.02.001. Epub 2009 Mar 13.
8
Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics.
Knee Surg Sports Traumatol Arthrosc. 2018 Jun;26(6):1671-1680. doi: 10.1007/s00167-017-4682-8. Epub 2017 Aug 28.
9
Kinematic changes in patients with severe knee osteoarthritis are a result of reduced walking speed rather than disease severity.
Gait Posture. 2020 Jun;79:256-261. doi: 10.1016/j.gaitpost.2020.05.008. Epub 2020 May 16.
10
Self-reported walking difficulty and knee osteoarthritis influences limb dynamics and muscle co-contraction during gait.
Hum Mov Sci. 2019 Apr;64:409-419. doi: 10.1016/j.humov.2018.11.002. Epub 2018 Nov 15.

本文引用的文献

2
The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis.
Clin Biomech (Bristol). 2016 Jan;31:40-6. doi: 10.1016/j.clinbiomech.2015.10.003. Epub 2015 Oct 9.
3
Altered gait characteristics in individuals with knee osteoarthritis and self-reported knee instability.
J Orthop Sports Phys Ther. 2015 May;45(5):351-9. doi: 10.2519/jospt.2015.5540. Epub 2015 Mar 26.
4
Challenges in dealing with walking speed in knee osteoarthritis gait analyses.
Clin Biomech (Bristol). 2012 Mar;27(3):210-2. doi: 10.1016/j.clinbiomech.2011.09.009. Epub 2011 Oct 22.
6
Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations.
Disabil Rehabil. 2011;33(13-14):1103-9. doi: 10.3109/09638288.2010.520805. Epub 2011 Jan 5.
7
Gait modification strategies for altering medial knee joint load: a systematic review.
Arthritis Care Res (Hoboken). 2011 Mar;63(3):405-26. doi: 10.1002/acr.20380. Epub 2010 Oct 27.
8
Sex differences in biomechanics associated with knee osteoarthritis.
J Women Aging. 2009;21(3):159-70. doi: 10.1080/08952840903054856.
9
White paper: "walking speed: the sixth vital sign".
J Geriatr Phys Ther. 2009;32(2):46-9.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验