Latz David, Schiffner Erik, Schneppendahl Johannes, Klein Konstantin, Oezel Lisa, Seiler Lars Fabian, Jungbluth Pascal, Kaufmann Robert Alexander, Windolf Joachim, Gehrmann Sebastian Viktor
Department of Trauma and Hand Surgery, University Hospital, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Department of Trauma and Hand Surgery, University Hospital, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Knee. 2019 Jan;26(1):33-39. doi: 10.1016/j.knee.2018.11.005. Epub 2018 Nov 29.
One of the most important activities of daily living is operating a motor vehicle. With increasing age the prevalence of musculoskeletal disorders such as knee osteoarthritis may interfere with an individual's ability to do so safely. Physicians are tasked with determining a patient's ability to drive and yet the necessary joint range of motion required for driving a car has not been characterized.
The range of motion of the right and left knees was recorded using electrogoniometers in 20 healthy subjects while driving a car on three route types (a) city streets, b) country roads and c) highways). Special emphasis was placed on the left knee associated with changing a gear.
The range of motion while driving is 40-80° for the right and 20-85° flexion for the left knee. A significant difference was noted for each side (p < 0.01) with a higher flexion occurring in the left knee (p < 0.01). The average position of the knee while changing a gear (beginning, maximum, ending) was: right: 55°±10°, 62°±10°, 53°±10°; left: 67°±7°, 39°±8°, 66°±8° (mean flexion±standard deviation).
This study characterized the knee range of motion that occurs while driving a car. Our data suggests that common driving activities such as accelerating a vehicle or braking can be achieved with the right knee through a limited range of motion. The greater range of motion and the higher flexion of the left knee are mainly attributed to the gear changing. The present data may benefit physicians in their evaluation of driving capability.
驾驶机动车是日常生活中最重要的活动之一。随着年龄的增长，诸如膝关节骨关节炎等肌肉骨骼疾病的患病率可能会干扰个体安全驾驶的能力。医生的任务是确定患者的驾驶能力，但驾驶汽车所需的必要关节活动范围尚未明确。
使用电子测角仪记录20名健康受试者在驾驶汽车时在三种路线类型（a）城市街道、b）乡村道路和c）高速公路）上左右膝关节的活动范围。特别强调与换挡相关的左膝。
驾驶时右膝的活动范围为40 - 80°，左膝的屈曲范围为20 - 85°。两侧均有显著差异（p < 0.01），左膝屈曲度更高（p < 0.01）。换挡时（开始、最大、结束）膝关节的平均位置为：右：55°±10°、62°±10°、53°±10°；左：67°±7°、39°±8°、66°±8°（平均屈曲度±标准差）。
本研究明确了驾驶汽车时膝关节的活动范围。我们的数据表明，诸如加速或刹车等常见驾驶活动，右膝通过有限的活动范围即可完成。左膝更大的活动范围和更高的屈曲度主要归因于换挡。目前的数据可能有助于医生评估驾驶能力。
