Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
School of Exercise and Nutrition Sciences, Centre for Sports Research, Deakin University, Melbourne, Australia.
J Orthop Res. 2020 Aug;38(8):1836-1844. doi: 10.1002/jor.24609. Epub 2020 Jan 31.
This study aimed to evaluate hip joint kinematic variability and segment coordination variability during walking according to pain and radiographic disease severity in people with hip osteoarthritis. Fifty-five participants with hip osteoarthritis had pain severity assessed during walking using an item on the Western Ontario and McMasters Universities Osteoarthritis Index (no pain = 10; mild pain = 28; moderate pain = 17). Radiographic disease severity was graded by Kellgren and Lawrence scale (KL2 = 29; KL3 = 21; KL4 = 5). Hip kinematics variability was estimated as the curve coefficient of variation. Vector coding was used to calculate coordination variability for select joint couplings. One-way analysis of variances with planned adjusted post hoc comparisons were used to compare hip kinematics variability and coordination variability of select segment couplings (pelvis sagittal vs thigh sagittal; pelvis frontal vs thigh frontal; pelvis transverse vs thigh transverse; thigh sagittal vs shank sagittal; thigh frontal vs shank sagittal; thigh transverse vs shank sagittal) according to pain and radiographic disease severity. No main effect of pain severity was observed for sagittal or transverse plane hip kinematic variability (P ≥ .266), and although there was a main effect for frontal plane hip kinematic variability (P = .035), there were no significant differences when comparing between levels of pain severity (P > .006). There was no main effect of radiographic disease severity on hip kinematic variability in the sagittal (P = .539) or frontal (P = .307) plane. No significant differences in coordination of variability of segment couplings were observed (all P ≥ .229). Movement variability as assessed in this study did not differ according to pain severity during walking or radiographic disease severity.
本研究旨在评估髋关节炎患者在行走过程中髋关节运动学变异性和节段协调性变异性与疼痛和放射学疾病严重程度的关系。55 名髋关节炎患者在行走时通过 Western Ontario and McMasters Universities Osteoarthritis Index（无疼痛=10；轻度疼痛=28；中度疼痛=17）评估疼痛严重程度。放射学疾病严重程度按 Kellgren 和 Lawrence 分级（KL2=29；KL3=21；KL4=5）。髋关节运动学变异性用曲线变异系数来估计。矢量编码用于计算选择关节耦合的协调性变异性。使用单向方差分析，对有计划的事后调整进行比较，根据疼痛和放射学疾病严重程度比较选择节段耦合的髋关节运动学变异性和协调性变异性（骨盆矢状位与大腿矢状位；骨盆额状位与大腿额状位；骨盆横断位与大腿横断位；大腿矢状位与小腿矢状位；大腿额状位与小腿矢状位；大腿横断位与小腿矢状位）。在矢状面或横断面上，疼痛严重程度对髋关节运动学变异性没有主要影响（P≥.266），虽然额状面髋关节运动学变异性有主要影响（P=0.035），但在比较不同疼痛严重程度时没有显著差异（P＞.006）。在矢状面（P=0.539）或额状面（P=0.307）上，放射学疾病严重程度对髋关节运动学变异性没有主要影响。在节段耦合的变异性协调方面没有观察到显著差异（所有 P≥.229）。在这项研究中评估的运动变异性没有根据行走时的疼痛严重程度或放射学疾病严重程度而有所不同。
