Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC.
Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
Sci Rep. 2021 Feb 12;11(1):3742. doi: 10.1038/s41598-021-83233-w.
About half of the elderly population has knee osteoarthritis (OA), showing altered gait patterns with increased fall risk. The current study aimed to identify the effects of severe bilateral medial knee osteoarthritis on gait balance control, in terms of the inclination angle (IA) of the center of pressure to center of mass vector, and the rate of change of IA (RCIA). Fifteen older adults with severe bilateral medial knee OA and 15 healthy controls walked at their preferred walking speed while the kinematic and forceplate data were measured to calculate IA, RCIA and temporal-spatial parameters. The OA group showed compromised gait balance control, due to a decreased average and range of sagittal RCIA over double-limb support (DLS, p < 0.002) and single-limb support (SLS, p < 0.002), as well as an increased sagittal IA (DLS, p < 0.005). Significantly decreased frontal RCIA averages during DLS, heel-strike and toe-off, and decreased RCIA ranges during SLS and swing (p < 0.027) were also observed. Reducing RCIA during DLS appeared to help reduce the loading rate and pain at the knees, and reduced RCIA at the subsequent SLS. The results indicated an increased risk of loss of balance in the OA group, and may warrant regular monitoring for reduced RCIA during gait to determine fall risk.
约半数老年人患有膝关节骨关节炎（OA），表现为步态模式改变，跌倒风险增加。本研究旨在从足底压力中心到质心向量的倾斜角（IA）和 IA 的变化率（RCIA）方面，确定严重双侧膝关节内侧 OA 对步态平衡控制的影响。15 名患有严重双侧膝关节内侧 OA 的老年人和 15 名健康对照者以他们的习惯行走速度行走，同时测量运动学和测力板数据以计算 IA、RCIA 和时空参数。OA 组的步态平衡控制能力受损，这是由于在双足支撑（DLS）和单足支撑（SLS）时矢状面 RCIA 的平均和范围均减小（p<0.002），以及矢状面 IA 增大（DLS，p<0.005）所致。还观察到 DLS 期间的额状面 RCIA 平均值显著降低，跟骨触地和脚趾离地期间的 RCIA 范围降低，以及 SLS 和摆动期间的 RCIA 范围降低（p<0.027）。DLS 期间 RCIA 的减少似乎有助于减轻膝关节的负荷率和疼痛，并减少随后的 SLS 中的 RCIA。结果表明 OA 组失去平衡的风险增加，可能需要定期监测步态中 RCIA 的减少，以确定跌倒风险。
