Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
Gait Posture. 2020 Jun;79:256-261. doi: 10.1016/j.gaitpost.2020.05.008. Epub 2020 May 16.
Kinematic changes in patients with knee osteoarthritis (OA) have been extensively studied. Concerns have been raised whether the measured spatiotemporal and kinematic alterations are associated with disease progression or merely a result of reduced walking speed.
The purpose of this study was to investigate the effect of walking speed on kinematic parameters in patients with knee OA using statistical parametric mapping (SPM).
Twenty-three patients with unilateral knee OA scheduled for a total knee replacement and 28 age matched control subjects were included in this study. Spatiotemporal parameters and sagittal plane kinematics were measured in the hip, knee, and ankle using the inertial sensors system RehaGait® while walking at a self-selected normal (patients and controls) and slow walking speed (controls) for a distance of 20 m. Gait parameters were compared between groups for self-selected walking speed and for matched walking speed using SPM with independent sample t tests.
At self-selected walking speed, patients had significantly lower knee flexion during stance (maximum difference, -6.8°) and during swing (-11.0°), as well as higher ankle dorsiflexion during stance phase (+12.5°) and lower peak hip extension at the end of stance compared to controls (+4.2°). At matched speed, there were no significant differences in joint kinematics between groups.
Differences in sagittal plane gait kinematics between patients with knee OA and asymptomatic controls appear to be mainly a result of reduced walking speed. These results emphasize the importance of considering walking speed in research on gait kinematics in patients with knee OA and in clinical trials using gait parameters as outcome measures.
膝关节骨关节炎（OA）患者的运动学变化已得到广泛研究。人们担心所测量的时空和运动学改变是否与疾病进展有关，还是仅仅是由于行走速度降低的结果。
本研究的目的是使用统计参数映射（SPM）研究行走速度对膝关节 OA 患者运动学参数的影响。
本研究纳入了 23 名单侧膝关节 OA 患者和 28 名年龄匹配的对照组受试者。使用惯性传感器系统 RehaGait®在自我选择的正常（患者和对照组）和慢步行速（对照组）下行走 20m 时，测量髋关节、膝关节和踝关节的时空参数和矢状面运动学。使用独立样本 t 检验的 SPM 比较组间自我选择行走速度和匹配行走速度的步态参数。
在自我选择的行走速度下，患者在站立期（最大差异，-6.8°）和摆动期（-11.0°）的膝关节屈曲度明显较低，站立期的踝关节背屈度较高（+12.5°），站立末期的髋关节伸展峰值较低（+4.2°）。在匹配的速度下，组间的关节运动学没有显著差异。
膝关节 OA 患者和无症状对照组之间矢状面步态运动学的差异似乎主要是由于行走速度降低所致。这些结果强调了在膝关节 OA 患者的步态运动学研究和使用步态参数作为疗效指标的临床试验中考虑行走速度的重要性。
