Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA.
Tennessee Orthopedic Clinics, Knoxville, TN 37923, USA.
J Sport Health Sci. 2022 Jan;11(1):50-57. doi: 10.1016/j.jshs.2021.01.009. Epub 2021 Feb 1.
The purpose of this study was to compare knee biomechanics of the replaced limb to the non-replaced limb of total knee replacement (TKR) patients and healthy controls during walking on level ground and on decline surfaces of 5°, 10°, and 15°.
Twenty-five TKR patients and 10 healthy controls performed 5 walking trials on different decline slopes on a force platform and an instrumented ramp system. Two analyses of variance, 2 × 2 (limb × group) and 2 × 4 (limb × decline slope), were used to examine selected biomechanics variables.
The replaced limb of TKR patients had lower peak loading-response and push-off knee extension moment than the non-replaced and the matched limb of healthy controls. No differences were found in loading-response and push-off knee internal abduction moments among replaced, non-replaced, and matched limb of healthy controls. The knee flexion range of motion, peak loading-response vertical ground reaction force, and peak knee extension moment increased across all slope comparisons between 0° and 15° in both the replaced and non-replaced limb of TKR patients.
Downhill walking may not be appropriate to include in early stage rehabilitation exercise protocols for TKR patients.
本研究旨在比较全膝关节置换（TKR）患者和健康对照者在平地上和 5°、10°、15°下坡面上行走时，置换侧和非置换侧膝关节的生物力学差异。
25 例 TKR 患者和 10 例健康对照者在力平台和仪器化斜坡系统上进行了 5 次不同坡度的行走试验。采用 2×2（肢体×组）和 2×4（肢体×下坡坡度）方差分析来评估选定的生物力学变量。
TKR 患者置换侧的峰值负荷反应和蹬离膝伸肌力矩低于非置换侧和健康对照组的匹配侧。在健康对照组的置换侧、非置换侧和匹配侧，负荷反应和蹬离膝内收肌力矩没有差异。在 TKR 患者的置换侧和非置换侧，膝关节屈曲度、峰值负荷反应垂直地面反作用力和峰值膝伸肌力矩在从 0°到 15°的所有坡度比较中均增加。
下坡行走可能不适合纳入 TKR 患者早期康复锻炼方案。
