膝骨关节炎患者膝状神经阻滞后下肢运动学改善：一项使用惯性传感器的里程碑式研究。
Lower limb kinematics improvement after genicular nerve blockade in patients with knee osteoarthritis: a milestone study using inertial sensors.
作者信息
Lebleu Julien, Fonkoue Loic, Bandolo Eric, Fossoh Herman, Mahaudens Philippe, Cornu Olivier, Detrembleur Christine
机构信息
Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Secteur des Sciences de la Santé, Avenue Mounier 53, B-1200, Brussels, Belgium.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon.
出版信息
BMC Musculoskelet Disord. 2020 Dec 7;21(1):822. doi: 10.1186/s12891-020-03836-8.
BACKGROUND
Genicular nerve blockade is a possible treatment for patients with knee osteoarthritis. Pain relief and improvement in functioning is expected. This procedure could be of major interest for patients in low-income countries where total knee arthroplasty is not available for the population. This study aims at assessing the immediate benefits on pain, gait, and stairs kinematics after a genicular nerve blockade in patients suffering from knee osteoarthritis in Cameroun.
METHODS
A prospective study was carried out on 26 subjects in Cameroun. A genicular nerve blockade was performed on 14 women with painful knee osteoarthritis grade 2-4. Lower limb joint angles were recorded with inertial sensors before and 1 h after injection. Patient-reported outcomes of pain and perceived difficulty were collected, as well as 10 m and 6 min walking tests. A reliability analysis of inertial sensors was performed on a sample of 12 healthy subjects by calculating the intraclass correlation coefficient and the standard error of measurement.
RESULTS
Pain and perceived difficulty decreased significantly (p < 0.001). Cadence increased significantly in stairs climbing (upstairs: + 7.7 steps/min; downstairs: + 7.6 steps/min). There was an improvement for hip sagittal range of motion during gait (+ 9.3°) and pelvis transverse range of motion in walking upstairs (- 3.3°). Angular speed range of the knee in the sagittal plane and of the hip in the frontal plane increased significantly in stairs descent (+ 53.7°/s, + 94.5°/s).
CONCLUSIONS
This study quantified improvement of gait and stair climbing immediately after a genicular nerve blockade in patients suffering from knee OA in Cameroon. This is the first study objectifying this effect, through wearable sensors.
TRIAL REGISTRATION
Pan African Clinical Trial Registry, PACTR202004822698484 . Registered 28 March 2020 - Retrospectively registered.
背景
膝神经阻滞是膝骨关节炎患者的一种可能治疗方法。预期可缓解疼痛并改善功能。对于低收入国家中无法进行全膝关节置换术的人群而言，该手术可能具有重大意义。本研究旨在评估喀麦隆膝骨关节炎患者接受膝神经阻滞术后对疼痛、步态和上下楼梯运动学的即时益处。
方法
在喀麦隆对26名受试者进行了一项前瞻性研究。对14名患有2 - 4级疼痛性膝骨关节炎的女性实施了膝神经阻滞。在注射前和注射后1小时，使用惯性传感器记录下肢关节角度。收集患者报告的疼痛和感知困难结果，以及10米和6分钟步行测试结果。通过计算组内相关系数和测量标准误差，对12名健康受试者的样本进行了惯性传感器的可靠性分析。
结果
疼痛和感知困难显著降低（p < 0.001）。上下楼梯时步频显著增加（上楼：+7.7步/分钟；下楼：+7.6步/分钟）。步态期间髋关节矢状面活动范围有所改善（+9.3°），上楼时骨盆横断面活动范围有所改善（-3.3°）。下楼梯时膝关节矢状面角速度范围和髋关节额状面角速度范围显著增加（+53.7°/秒，+94.5°/秒）。
结论
本研究量化了喀麦隆膝骨关节炎患者接受膝神经阻滞后步态和上下楼梯能力的即时改善。这是第一项通过可穿戴传感器客观证实这种效果的研究。
试验注册
泛非临床试验注册中心，PACTR202004822698484。2020年3月28日注册 - 追溯注册。
Zotero 插件