Moissenet Florent, Naaim Alexandre, Ornetti Paul, Bourredjem Abderrahmane, Binquet Christine, Morisset Claire, Gouteron Anais, Maillefert Jean-Francis, Laroche Davy
Kinesiology Laboratory, University of Geneva, Geneva, Switzerland.
Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR T9406, Lyon, France.
Front Bioeng Biotechnol. 2020 Jan 23;7:457. doi: 10.3389/fbioe.2019.00457. eCollection 2019.
The evaluation of the disease severity in hip osteoarthritis (OA) patients being currently based on subjective instruments. It would be of interest to develop more objective instruments, for example based on gait analysis. The aims of this study were to explore if pelvis-thorax coordination parameters could be valuable instrument outcomes to achieve this evaluation by assessing their reliability, discriminant capacity and responsiveness. Three groups of subjects; healthy, hip OA patients with severe disease (defined as indication to surgery), hip OA patients with less severe disease (no indication to surgery) were included. Hip OA patients with severe disease were evaluated before and 6 months after surgery. Subjects had to perform a gait analysis at comfortable speed, and pelvis-thorax coordination was evaluated. The correlations with clinical and structural parameters, as well as reliability, discriminant capacities and responsiveness, were assessed. The pelvis-thorax coordination in the coronal plane during walking was correlated to clinical and to structural severity in hip OA patients ( = 0.13). The coronal plane coordination allowed to discriminate healthy subjects from all hip OA patients (sensibility = 0.86; specificity = 0.59). Moreover, when comparing OA patients only, coronal plane coordination allows to discriminate patients with indication of surgery from those with no indication of surgery (sensibility = 0.72; specificity = 0.72). Moreover, the pelvis-thorax coordination demonstrated an excellent reliability and a good responsiveness. Changes in the pelvis-thorax coordination might refer to different mechanisms, from analgesia to motor control plasticity, and might be a possible explanation for the weak correlation between structure and symptoms in hip OA patients. Moreover, such parameter might be used as an objective outcome in hip OA clinical trials. www.ClinicalTrials.gov, identifier: NCT02042586 and NCT01907503.
目前，髋骨关节炎（OA）患者疾病严重程度的评估基于主观工具。开发更客观的工具会很有意义，例如基于步态分析的工具。本研究的目的是通过评估骨盆 - 胸廓协调参数的可靠性、判别能力和反应性，探讨其是否可作为实现这一评估的有价值的工具结果。纳入了三组受试者：健康受试者、患有严重疾病（定义为有手术指征）的髋OA患者、患有较轻疾病（无手术指征）的髋OA患者。对患有严重疾病的髋OA患者在手术前和术后6个月进行评估。受试者必须以舒适的速度进行步态分析，并评估骨盆 - 胸廓协调性。评估了其与临床和结构参数的相关性，以及可靠性、判别能力和反应性。行走过程中冠状面的骨盆 - 胸廓协调性与髋OA患者的临床和结构严重程度相关（ = 0.13）。冠状面协调性能够区分健康受试者与所有髋OA患者（敏感性 = 0.86；特异性 = 0.59）。此外，仅比较OA患者时，冠状面协调性能够区分有手术指征的患者和无手术指征的患者（敏感性 = 0.72；特异性 = 0.72）。此外，骨盆 - 胸廓协调性表现出极好的可靠性和良好的反应性。骨盆 - 胸廓协调性的变化可能涉及不同机制，从镇痛到运动控制可塑性，并且可能是髋OA患者结构与症状之间弱相关性的一种可能解释。此外，这样的参数可作为髋OA临床试验中的客观结果。www.ClinicalTrials.gov，标识符：NCT02042586和NCT01907503。
