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髋外展肌无力和膝关节骨关节炎患者转身动作缓慢。

Hip abductor muscle weakness and slowed turning motion in people with knee osteoarthritis.

机构信息

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.

Graduate School of Science and Technology, Keio University, Yokohama, Japan.

出版信息

J Biomech. 2020 Mar 5;101:109652. doi: 10.1016/j.jbiomech.2020.109652. Epub 2020 Jan 24.

Abstract

Laser range sensor-based timed up and go (laser-TUG) test can evaluate performance in TUG subtasks (sit-to-walk [STW], walking a short distance, and turning). This study aimed to test the hypothesis that weaker hip abductor muscle strength is more significantly associated with slowed turning speed than with the other TUG subtasks (STW and straight walking) after controlling for quadriceps muscle strength in patients with knee osteoarthritis (OA). Community-dwelling participants with knee OA (Kellgren and Lawrence [K&L] grade ≥ 1; mean age, 68.6 years; 70.3% women) underwent laser-TUG. Spatiotemporal gait parameters in TUG and the TUG subtasks were evaluated as outcome measures. The isometric muscle strength of the hip abductor and quadriceps was measured using a hand-held dynamometer. Multiple linear regression analysis was performed to examine the relationship between muscle strength as an independent variable and spatiotemporal parameters as dependent variables. The relative importance of hip abductor muscle strength was determined using the percentages of unique variance. Participants with weaker hip abductor muscle strength demonstrated 0.094 m/s slower turning speed after adjustment for covariates including quadriceps muscle strength. The unique variance explained by hip abductor muscle strength in turning speed was 2.1%. However, no significant relationships were confirmed between weak hip abductor muscle strength and the time to perform TUG and the straight walking (forward and return) phase. These findings indicate that turning motion may be more sensitive to aggravated hip abductor muscle weakness and may show better response to hip muscle strengthening exercises. Longitudinal studies are warranted to elucidate this issue.

摘要

基于激光测距传感器的计时起立行走测试(激光-TUG)可以评估 TUG 子任务(从坐到站[STW]、短距离行走和转身)中的表现。本研究旨在检验以下假设:在控制膝关节骨关节炎(OA)患者的股四头肌力量后,与其他 TUG 子任务(STW 和直线行走)相比,较弱的髋关节外展肌力量与转身速度较慢的相关性更大。本研究纳入了社区居住的膝关节 OA 患者(Kellgren 和 Lawrence [K&L] 分级≥1;平均年龄 68.6 岁;70.3%为女性),并对其进行了激光-TUG 测试。TUG 和 TUG 子任务中的时空步态参数作为结局指标进行评估。使用手持测力计测量髋关节外展肌和股四头肌的等长肌力。采用多元线性回归分析,以肌肉力量作为自变量,时空参数作为因变量,检验两者之间的关系。采用独特方差百分比确定髋关节外展肌力量的重要性。调整包括股四头肌力量在内的协变量后,髋关节外展肌力量较弱的患者转身速度减慢了 0.094m/s。髋关节外展肌力量对转身速度的独特方差解释率为 2.1%。然而,在髋关节外展肌力量与 TUG 时间和直线行走(前进和返回)阶段之间未确认到显著的相关性。这些发现表明,转身运动可能对髋关节外展肌力量减弱更为敏感,并且可能对髋关节肌肉强化锻炼有更好的反应。需要进行纵向研究来阐明这一问题。

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