Hughes-Oliver C N, Srinivasan D, Schmitt D, Queen R M
Department of Biomedical Engineering and Mechanics, 495 Old Turner Street Blacksburg, VA, 24060, 208 Norris Hall, USA.
Department of Industrial Systems Engineering, 1185 Perry Street Blacksburg, VA, 24060, 549 Whittemore Hall, USA.
Gait Posture. 2018 Sep;65:228-233. doi: 10.1016/j.gaitpost.2018.07.180. Epub 2018 Jul 31.
The effects of ankle osteoarthritis on gait are noticeable in the clinic, but are difficult to quantify and score without detailed kinematic and kinetic analysis. Evaluationof temporal gait parameters and gait variability is a potential alternative.
This study aimed to determine associations between limb and gender with temporal gait parameters and gait variability in ankle OA patients to evaluate the utility of these parameters for gait assessment in a clinical setting.
Following informed consent, 242 end-stage unilateral ankle OA patients walked at self-selected speed across force plates. Means and stride-to-stride standard deviations (SD) of stride, swing, stance, and double support times were determined for each patient. Limb x Gender ANCOVA models co-varying for walking speed were run for swing and stance times, while stride and double support times were only compared between genders. Statistical analysis was performed in SPSS (α = 0.05).
Walking speed affected all measures of interest. After adjusting for walking speed, mean stride time, stride time SD, and stance time SD were 3.5%, 67% and 29% higher among women than men (p = 0.002, 0.035 and 0.02 respectively). Swing time was 12% higher and stance time was 6% lower on the affected side compared to the unaffected side (p < 0.001 for both).
Women have longer stride times and higher variability, which may indicate higher fall risk. Both genders minimized loading on the affected limb by increasing swing time and reducing stance time on the affected side. Simple, easy to record temporal gait patterns can provide useful insight into gait abnormalities in patients with ankle OA.
踝关节骨关节炎对步态的影响在临床上很明显,但如果没有详细的运动学和动力学分析,很难进行量化和评分。评估步态时间参数和步态变异性是一种潜在的替代方法。
本研究旨在确定踝关节骨关节炎患者的肢体和性别与步态时间参数和步态变异性之间的关联,以评估这些参数在临床环境中用于步态评估的效用。
在获得知情同意后,242例终末期单侧踝关节骨关节炎患者以自选速度走过测力板。确定每位患者的步幅、摆动、站立和双支撑时间的平均值以及步幅间标准差(SD)。针对摆动和站立时间,运行了协变量为步行速度的肢体×性别协方差分析模型,而步幅和双支撑时间仅在性别之间进行比较。在SPSS中进行统计分析(α = 0.05)。
步行速度影响所有感兴趣的指标。在调整步行速度后,女性的平均步幅时间、步幅时间标准差和站立时间标准差分别比男性高3.5%、67%和29%(p分别为0.002、0.035和0.02)。与未受影响侧相比,受影响侧的摆动时间高12%,站立时间低6%(两者p均<0.001)。
女性的步幅时间更长且变异性更高,这可能表明跌倒风险更高。两性都通过增加摆动时间和减少受影响侧的站立时间来尽量减少受影响肢体的负荷。简单、易于记录的步态时间模式可为踝关节骨关节炎患者的步态异常提供有用的见解。