Philp Fraser, Leboeuf Fabien, Pandyan Anand, Stewart Caroline
School of Health and Rehabilitation, Keele University, ST5 5BG, UK; Institute of Science and Technology in Medicine, Keele University, ST5 5BG, UK.
School of Health Science, University of Salford, M6 6PU, UK.
Gait Posture. 2019 May;70:298-304. doi: 10.1016/j.gaitpost.2019.03.006. Epub 2019 Mar 11.
"Dynamic knee valgus" has been identified as a risk factor for significant knee injuries, however, the limits and sources of error associated with existing 3D motion analysis methods have not been well established.
What effect does the use of differing static and functional knee axis orientation methods have on the observed knee angle outputs for the activities of gait, overhead squatting and a hurdle step?
A pre-existing dataset collected from one season (September 2015-May 2016) as part of a prospective observational longitudinal study was used. A secondary analysis of data for 24 male footballers, from a single British University football team, was conducted in order to evaluate the effect of static (conventional gait model) and dynamic (constrained and unconstrained mDynaKAD) methods on knee joint kinematics for flexion-extension and valgus-varus angles.
No single calibration method consistently achieved both the highest flexion and lowest valgus angle for all tests. The constrained and unconstrained mDynaKAD methods achieved superior alignment of the knee medio-lateral axis compared to the conventional gait model, when the movement activity served as its own calibration. The largest mean difference between methods for sagittal and coronal plane kinematics was less than 4° and 14° respectively. Cross-talk could not account for all variation within the results, highlighting that soft tissue artefact, associated with larger muscle volumes and movements, can influence kinematics results.
When considering the trade-off between achieving maximum flexion and minimal valgus angle, the results indicate that the mDynaKAD methods performed best when the selected movement activity served as its own calibration method for all activities. Clinical decision making processes obtained through use of these methods should be considered in light of the model errors associated with cross-talk and effect of soft tissue artefact.
“动态膝外翻”已被确定为严重膝关节损伤的一个风险因素，然而，与现有三维运动分析方法相关的误差限度和来源尚未得到充分证实。
使用不同的静态和功能性膝关节轴定向方法对步态、过头深蹲和跨栏步活动中观察到的膝关节角度输出有何影响？
使用了作为一项前瞻性观察性纵向研究的一部分，从一个赛季（2015年9月至2016年5月）收集的已有数据集。对来自英国一所大学的单一足球队的24名男性足球运动员的数据进行二次分析，以评估静态（传统步态模型）和动态（约束和非约束mDynaKAD）方法对膝关节屈伸和内外翻角度运动学的影响。
没有一种单一的校准方法在所有测试中都能始终如一地实现最大屈曲和最小外翻角度。当运动活动作为自身校准时，与传统步态模型相比，约束和非约束mDynaKAD方法实现了膝关节中外侧轴的更好对齐。矢状面和冠状面运动学方法之间的最大平均差异分别小于4°和14°。串扰无法解释结果中的所有变化，这突出表明与较大肌肉体积和运动相关的软组织伪影会影响运动学结果。
在考虑实现最大屈曲和最小外翻角度之间的权衡时，结果表明，当所选运动活动作为所有活动的自身校准方法时，mDynaKAD方法表现最佳。应根据与串扰相关的模型误差和软组织伪影的影响，来考虑通过使用这些方法获得的临床决策过程。
