Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan; Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Japan Society for the Promotion of Science, Tokyo, Japan; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, United States; McGowan Institute for Regenerative Medicine, University of Pittsburgh, United States.
School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Yokohama, Japan.
Gait Posture. 2019 Jul;72:148-153. doi: 10.1016/j.gaitpost.2019.06.004. Epub 2019 Jun 6.
A growing clinical interest has been shown towards identifying knee osteoarthritis (OA) patients at earlier stages. The early detection of knee OA may allow for more effective interventions.
The aim of this study was to determine the discriminative ability of a stair-climb test (SCT) in identifying patients with early knee OA, and to determine if descending stair time during the SCT is better than ascending stair time for the identification of these patients.
This study was a secondary, cross-sectional analysis of baseline data from a randomized controlled trial. Adults with moderate to severe knee pain were enrolled (n = 57; mean age 58.9 years; 71.9% women). Each participant performed an 11-step SCT (11-SCT) while wearing shoes with a pressure sensor insole. A receiver operating characteristic analysis was used to examine the discriminative power of 11-SCT for identifying early knee OA (Kellgren and Lawrence grade 1). The discriminative power was also compared between the ascending and descending 11-SCT time as evaluated by the pressure sensor.
The 11-SCT time in patients with early knee OA was 0.55 s longer than that in those with symptomatic non-radiographic OA. A one-second increase in the 11-SCT time was significantly associated with 1.9-fold increased odds of early knee OA being present. The 11-SCT value with the best balance of sensitivity and specificity for identifying early knee OA was 8.33 s (area under the curve: 0.711). The descending time was not significantly better than the ascending time for identifying early knee OA.
This study determined the time values of an 11-SCT that may be useful for identifying early knee OA patients. These preliminary findings may serve as the foundation for future studies investigating the clinical hallmarks associated with early knee OA.
人们对识别早期膝关节骨关节炎（OA）患者的临床兴趣日益浓厚。早期发现膝关节 OA 可能会使干预措施更有效。
本研究旨在确定爬楼梯测试（SCT）在识别早期膝关节 OA 患者方面的区分能力，并确定 SCT 中下楼时间是否比上楼时间更有助于识别这些患者。
本研究是一项随机对照试验的基线数据的二次横断面分析。招募了有中度至重度膝关节疼痛的成年人（n=57；平均年龄 58.9 岁；71.9%为女性）。每位参与者穿着带有压力传感器鞋垫的鞋子进行 11 步 SCT（11-SCT）。使用接收器操作特性分析来检查 11-SCT 识别早期膝关节 OA（Kellgren 和 Lawrence 分级 1）的区分能力。还通过压力传感器评估了 11-SCT 上升和下降时间之间的区分能力。
早期膝关节 OA 患者的 11-SCT 时间比有症状的非放射学 OA 患者长 0.55 秒。11-SCT 时间增加 1 秒，与早期膝关节 OA 发生的可能性增加 1.9 倍显著相关。用于识别早期膝关节 OA 的最佳敏感性和特异性的 11-SCT 值为 8.33 秒（曲线下面积：0.711）。下降时间在识别早期膝关节 OA 方面并不明显优于上升时间。
本研究确定了用于识别早期膝关节 OA 患者的 11-SCT 的时间值。这些初步发现可能为未来研究提供依据，以探讨与早期膝关节 OA 相关的临床特征。
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