Australian National University Medical School, Canberra, Australia.
University of Canberra Health Research Institute, University of Canberra, Canberra, Australia.
Clin Biomech (Bristol). 2020 Dec;80:105176. doi: 10.1016/j.clinbiomech.2020.105176. Epub 2020 Sep 18.
Gluteal-tendon repair is reported to be effective for relieving pain and improving function in patients with gluteal-tendon tears. However, post-operative three-dimensional gait analysis has never been conducted in gluteal-tendon repair patients. Thus, our primary aim was to investigate how biomechanical gait parameters differ between age- and sex-matched participants with and without gluteal-tendon repair.
Vicon motion analysis technology was used to measure gait characteristics of 25 gluteal-tendon repair participants and 29 matched healthy comparison group participants. A generalised linear multivariate model was used to compare external hip-adduction moment, range of movement in hip adduction and internal rotation, pelvic obliquity, trunk lean, stride length and velocity of both cohorts throughout stance.
There were no differences between the groups in external hip adduction moment, pelvic obliquity and range of movement in hip adduction and internal rotation. Gluteal-tendon repair participants had a shorter stride length (P = 0.031) and reduced walking velocity (P = 0.015). Ipsilateral trunk lean was reduced in gluteal-tendon repair participants at the first-peak external hip-adduction moment (P = 0.016), mid-stance minimum external hip-adduction moment (P = 0.029) and second-peak external hip-adduction moment (P = 0.006).
There were no differences between the gluteal-tendon repair and comparison groups for external hip-adduction moment and pelvic obliquity. This suggests that gluteal-tendon repair may restore hip control in stance. Slower walking speed, reduced stride length and decreased ipsilateral trunk lean may reflect persistence of pre-operatively developed gait adaptations. Future studies of gait biomechanics before and after gluteal-tendon repair would be needed to substantiate this theory.
臀肌腱修复术被报道可有效缓解臀肌腱撕裂患者的疼痛并改善其功能。然而，在臀肌腱修复患者中，从未进行过术后三维步态分析。因此，我们的主要目的是研究生物力学步态参数在接受和未接受臀肌腱修复的年龄和性别匹配的参与者之间有何不同。
使用 Vicon 运动分析技术测量 25 名臀肌腱修复参与者和 29 名匹配的健康对照组参与者的步态特征。使用广义线性多变量模型比较两组在整个站立期的髋关节外展力矩、髋关节内收和内旋活动范围、骨盆倾斜度、躯干倾斜、步长和速度。
两组在外展髋关节力矩、骨盆倾斜度和髋关节内收和内旋活动范围方面无差异。臀肌腱修复组的步长更短（P=0.031），行走速度更慢（P=0.015）。在第一峰值髋关节外展力矩（P=0.016）、中间最低髋关节外展力矩（P=0.029）和第二峰值髋关节外展力矩（P=0.006）时，臀肌腱修复组的同侧躯干倾斜减小。
在髋关节外展力矩和骨盆倾斜度方面，臀肌腱修复组和对照组之间无差异。这表明臀肌腱修复可能恢复了站立时的髋关节控制。较慢的步行速度、较短的步长和同侧躯干倾斜减小可能反映了术前已发展的步态适应性的持续存在。需要进行臀肌腱修复前后的步态生物力学研究来证实这一理论。
