Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Gait Posture. 2019 Sep;73:154-160. doi: 10.1016/j.gaitpost.2019.07.192. Epub 2019 Jul 16.
Negotiating stairs is an important activity of daily living that is also associated with large loads on the knee joint. In medial compartment knee osteoarthritis, the knee adduction moment during level walking is considered a marker for disease severity. It could be argued that the discriminative capability of this parameter is even better if tested in a strenuous stair negotiation task.
What is the relation with knee osteoarthritis on the knee adduction moment during the stance phase of both stair ascent and descent in patients with and without obesity?
This case control study included 22 lean controls, 16 lean knee osteoarthritis patients, and 14 obese knee osteoarthritis patients. All subjects ascended and descended a two-step staircase at a self-selected, comfortable speed. Three-dimensional motion analysis was performed to evaluate the knee adduction moment during stair negotiation.
Obese knee osteoarthritis patients show a prolonged stance time together with a more flattened knee adduction moment curve during stair ascent. Normalized knee adduction moment impulse, as well as the first and second peaks were not different between groups. During stair descent, a similar increase in stance time was found for both osteoarthritis groups.
The absence of a significant effect of groups on the normalized knee adduction moment during stair negotiation may be explained by a lower ambulatory speed in the obese knee osteoarthritis group, that effectively lowers vertical ground reaction force. Decreasing ambulatory speed may be an effective strategy to lower knee adduction moment during stair negotiation.
上下楼梯是日常生活中的一项重要活动，同时也是对膝关节的巨大负荷。在膝关节内侧间室骨关节炎中，水平行走时的膝关节内收力矩被认为是疾病严重程度的标志。有人认为，如果在费力的楼梯协商任务中测试，这个参数的辨别能力甚至更好。
在肥胖和非肥胖的膝骨关节炎患者中，在楼梯上升和下降的站立阶段，膝关节内收力矩与膝骨关节炎有什么关系？
这项病例对照研究包括 22 名瘦对照组、16 名瘦膝骨关节炎患者和 14 名肥胖膝骨关节炎患者。所有受试者以自选择的舒适速度登上两级楼梯。进行三维运动分析以评估楼梯协商期间的膝关节内收力矩。
肥胖的膝骨关节炎患者在上楼梯时表现出延长的站立时间，同时膝关节内收力矩曲线更加平坦。正常化的膝关节内收力矩脉冲以及第一和第二峰值在组间没有差异。在楼梯下降时，两组的站立时间都有类似的增加。
在楼梯协商过程中，正常化的膝关节内收力矩不受组间影响的情况可能是由于肥胖的膝骨关节炎组的步行速度较低，从而有效降低了垂直地面反作用力。降低步行速度可能是降低楼梯协商期间膝关节内收力矩的有效策略。
