University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Brigham and Women's Hospital, Boston, MA, USA.
Osteoarthritis Cartilage. 2019 May;27(5):771-780. doi: 10.1016/j.joca.2018.12.026. Epub 2019 Jan 18.
To compare sagittal walking gait biomechanics between participants with knee osteoarthritis (KOA) who increased quadriceps strength following a lower-extremity strengthening intervention (responders) and those who did not increase strength following the same strengthening protocol (non-responders) both at baseline and following the lower extremity strengthening protocol.
Fifty-three participants with radiographic KOA (47% female, 62.3 ± 7.1 years, BMI = 28.5 ± 3.9 kg/m) were enrolled in 10 sessions of lower extremity strengthening over a 28-day period. Maximum isometric quadriceps strength and walking gait biomechanics were collected on the involved limb at baseline and 4-weeks following the strengthening intervention. Responders were classified as individuals who increased quadriceps strength greater than the upper limit of the 95% confidence interval (CI) for the minimal detectable change (MDC) in quadriceps strength (29 Nm) determined in a previous study. 2 × 2 functional analyses of variance were used to evaluate the effects of group (responders and non-responders) and time (baseline and 4-weeks) on time-normalized waveforms for knee flexion angle (KFA), vertical ground reaction force (vGRF), and internal knee extension moment (KEM).
A significant group x time interaction for KFA demonstrated greater KFA in the first half of stance at baseline and greater knee extension in the second half of stance at 4-weeks in responders compared to non-responders. There was no significant group x time interaction for vGRF or internal KEM.
Quadriceps strengthening may be used to stimulate small changes in KFA in individuals with KOA.
比较膝关节骨关节炎（KOA）患者在下肢强化干预后增加股四头肌力量的（反应者）和未增加股四头肌力量的（非反应者）的矢状面行走步态生物力学，基线和下肢强化方案后均如此。
53 名有放射学 KOA 的参与者（47%为女性，62.3±7.1 岁，BMI=28.5±3.9kg/m）参加了为期 28 天的 10 次下肢强化课程。在基线和强化干预后 4 周，在受累肢体上收集最大等长股四头肌力量和行走步态生物力学。反应者被定义为股四头肌力量增加大于先前研究中确定的股四头肌力量最小可检测变化（MDC）的 95%置信区间（CI）上限（29Nm）的个体。使用 2×2 功能方差分析评估组（反应者和非反应者）和时间（基线和 4 周）对膝关节屈曲角度（KFA）、垂直地面反作用力（vGRF）和膝关节内伸力矩（KEM）时间归一化波形的影响。
KFA 的组 x 时间交互作用显著，与非反应者相比，反应者在基线时的站立初期膝关节屈曲角度更大，而在 4 周时的站立后期膝关节伸展角度更大。vGRF 或内部 KEM 没有显著的组 x 时间交互作用。
股四头肌强化可能用于刺激 KOA 患者 KFA 的微小变化。
