Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Orthopedics, Changhai Hospital Affiliated to the Second Military Medical University, No. 168 Changhai Road, Shanghai, China.
Clin Rheumatol. 2019 Apr;38(4):1163-1175. doi: 10.1007/s10067-018-4401-y. Epub 2019 Jan 4.
The aim of the study was to investigate the gait deviations of ankylosing spondylitis (AS) patients with hip involvement.
Thirty-six subjects, including 18 AS patients with hip involvement (AS group) and 18 healthy people (control subjects, CS group), were enrolled in the study. Three-dimensional gait analysis of the AS group and CS group was performed. Kinematic parameters, kinetic parameters and surface electromyography (sEMG) during the gait cycle were measured.
The AS patients with hip involvement had a lower gait velocity, shorter step length and shorter stride length. In the hip angles, there was significantly decreased flexion, excessive abduction and excessive external rotation; there was excessive flexion in the knee and reduction in plantar flexion of the ankle. AS patients had increased forward trunk flexion, excessive obliquity and restricted rotation of the trunk during the gait cycle. The hip moments of the AS group showed a significant reduction in flexion, abduction and external rotation during the gait cycle. The root mean square amplitude of the sEMG for the rectus femoris in the AS group was higher than that in the CS group.
The gait deviations in AS patients with hip involvement were described in this study. The gait analysis results demonstrated statistically significant alterations regarding the kinematic and kinetic gait parameters for the patients included in the sample. Coordination and balance were impaired by the disease. An efficient physical exercise plan can be formulated according to the results of gait analysis.
本研究旨在探讨髋关节受累的强直性脊柱炎（AS）患者的步态偏差。
本研究纳入了 36 名受试者，包括 18 例髋关节受累的 AS 患者（AS 组）和 18 名健康人（对照组）。对 AS 组和对照组进行三维步态分析，测量步态周期中的运动学参数、动力学参数和表面肌电图（sEMG）。
髋关节受累的 AS 患者的步行速度较低，步长和步幅较短。髋关节角度方面，存在明显的屈曲减少、过度外展和过度外旋；膝关节过度屈曲，踝关节跖屈减少。AS 患者在步态周期中存在明显的躯干前屈增加、过度倾斜和旋转受限。AS 组髋关节力矩在步态周期中表现出明显的屈曲、外展和外旋减少。AS 组股直肌的 sEMG 均方根振幅高于对照组。
本研究描述了髋关节受累的 AS 患者的步态偏差。步态分析结果表明，样本患者的运动学和动力学步态参数存在统计学显著改变。疾病导致协调和平衡受损。可以根据步态分析的结果制定有效的体育锻炼计划。
