Petrella Marina, Serrão Paula Regina Mendes da Silva, Selistre Luiz Fernando Approbato, Lessi Giovanna Camparis, Gonçalves Glaucia Helena, Mattiello Stela Márcia
Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP CEP:13565-905, Brazil.
Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP CEP:13565-905, Brazil.
Clin Biomech (Bristol). 2019 Dec;70:52-58. doi: 10.1016/j.clinbiomech.2019.07.029. Epub 2019 Jul 27.
Knee osteoarthritis tends to modify the kinematics and kinetics of the sit-to-stand task. However, it is not clear whether the different degrees of knee osteoarthritis differentiate regarding these aspects. The objective was to identify if the trunk flexion, lower limb kinetics, total support moment, and individual joint contributions to the total support moment during the sit-to-stand task are different between patients with mild and moderate knee osteoarthritis.
Sixty-two participants were grouped as follows: moderate knee osteoarthritis (n = 16), mild knee osteoarthritis (n = 25), and controls (n = 21). The participants performed a sit-to-stand task, which was analyzed using a 3D-motion system and a force plate.
The three phases of the sit-to-stand task were analyzed. During Phase, the moderate osteoarthritis group decreased the total support moment (P = 0.012). During Phase, the moderate osteoarthritis group showed higher trunk flexion (P = 0.023) and lower internal hip and knee extension moments (P ≤ 0.001 and P ≤ 0.040, respectively) when compared to controls. Also in Phase, both the mild and moderate groups used lower total support moment (P = 0.019, and P ≤ 0.001, respectively). When compared to the controls and mild osteoarthritis group those with moderate osteoarthritis presented higher hip joint contribution to the total support moment (P ≤ 0.001 and P = 0.006, respectively) as well as lower knee joint contribution (P ≤ 0.003 and P = 0,013, respectively).
Those with moderate osteoarthritis showed modified sit-to-stand movement pattern. While in Phase a higher contribution of the hip joint to the total support moment was observed, during previous phases the individuals were able to decrease the load on the knee without influencing the lower limb load distribution.
膝关节骨关节炎往往会改变从坐姿到站立任务的运动学和动力学。然而,不同程度的膝关节骨关节炎在这些方面是否存在差异尚不清楚。目的是确定轻度和中度膝关节骨关节炎患者在从坐姿到站立任务期间的躯干屈曲、下肢动力学、总支撑力矩以及各个关节对总支撑力矩的贡献是否不同。
62名参与者被分为以下几组:中度膝关节骨关节炎组(n = 16)、轻度膝关节骨关节炎组(n = 25)和对照组(n = 21)。参与者进行了从坐姿到站立的任务,使用三维运动系统和测力板对其进行分析。
对从坐姿到站立任务的三个阶段进行了分析。在阶段 ,中度骨关节炎组的总支撑力矩降低(P = 0.012)。在阶段 ,与对照组相比,中度骨关节炎组表现出更高的躯干屈曲(P = 0.023)以及更低的髋关节内收和膝关节伸展力矩(分别为P≤0.001和P≤0.040)。同样在阶段 ,轻度和中度组使用的总支撑力矩均较低(分别为P = 0.019和P≤0.001)。与对照组和轻度骨关节炎组相比,中度骨关节炎患者对总支撑力矩的髋关节贡献更高(分别为P≤0.001和P = 0.006),而膝关节贡献更低(分别为P≤0.003和P = 0.013)。
中度骨关节炎患者表现出改变的从坐姿到站立的运动模式。虽然在阶段 观察到髋关节对总支撑力矩的贡献更高,但在之前的阶段,个体能够在不影响下肢负荷分布的情况下减轻膝关节的负荷。