Lewis Cara L, Halverstadt Anne L, Graber Kerri A, Perkins Zoe, Keiser Emily, Belcher Hadwin, Khuu Anne, Loverro Kari L
Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States.
U.S. Army Combat Capabilities Development Command Soldier Center, Natick, MA, United States.
Front Sports Act Living. 2021 Aug 24;3:719097. doi: 10.3389/fspor.2021.719097. eCollection 2021.
Individuals with hip osteoarthritis (OA) commonly walk with less hip extension compared to individuals without hip OA. This alteration is often attributed to walking speed, structural limitation, and/or hip pain. It is unclear if individuals who are at increased risk for future OA (i.e., individuals with pre-arthritic hip disease [PAHD]) also walk with decreased hip extension. (1) Determine if individuals with PAHD exhibit less hip extension compared to individuals without hip pain during walking, and (2) investigate potential reasons for these motion alterations. Adolescent and adult individuals with PAHD and healthy controls without hip pain were recruited for the study. Kinematic data were collected while walking on a treadmill at three walking speeds: preferred, fast (25% faster than preferred), and prescribed (1.25 m/s). Peak hip extension, peak hip flexion, and hip excursion were calculated for each speed. Linear regression analyses were used to examine the effects of group, sex, side, and their interactions. Individuals with PAHD had 2.9° less peak hip extension compared to individuals in the Control group ( = 0.014) when walking at their preferred speed. At the prescribed speed, the PAHD group walked with 2.7° less hip extension than the Control group ( = 0.022). Given the persistence of the finding despite walking at the same speed, differences in preferred speed are unlikely the reason for the reduced hip extension. At the fast speed, both groups increased their hip extension, hip flexion, and hip excursion by similar amounts. Hip extension was less in the PAHD group compared to the Control group ( = 0.008) with no significant interaction ( = 0.206). Within the PAHD group, hip angles and excursions were similar between individuals reporting pain and individuals reporting no pain. The results of this study indicate that kinematic alterations common in individuals with hip OA exist early in the continuum of hip disease and are present in individuals with PAHD. The reduced hip extension during walking is not explained by speed, structural limitation, or current pain.
与没有髋骨关节炎(OA)的个体相比,患有髋骨关节炎的个体在行走时通常髋关节伸展幅度较小。这种改变通常归因于行走速度、结构限制和/或髋部疼痛。目前尚不清楚未来患OA风险增加的个体(即患有关节炎前期髋部疾病[PAHD]的个体)在行走时髋关节伸展幅度是否也会减小。(1)确定与无髋部疼痛的个体相比,患有PAHD的个体在行走时髋关节伸展幅度是否较小,以及(2)调查这些运动改变的潜在原因。招募了患有PAHD的青少年和成年人以及无髋部疼痛的健康对照者参与该研究。在跑步机上以三种行走速度行走时收集运动学数据:偏好速度、快速(比偏好速度快25%)和规定速度(1.25米/秒)。计算每种速度下的髋关节伸展峰值、髋关节屈曲峰值和髋关节活动度。使用线性回归分析来检验组、性别、侧别及其相互作用的影响。与对照组个体相比,患有PAHD的个体在以偏好速度行走时髋关节伸展峰值少2.9°(P = 0.014)。在规定速度下,PAHD组的髋关节伸展比对照组少2.7°(P = 0.022)。尽管以相同速度行走,但该发现仍然存在,因此偏好速度的差异不太可能是髋关节伸展减少的原因。在快速速度下,两组的髋关节伸展、髋关节屈曲和髋关节活动度增加的幅度相似。与对照组相比,PAHD组的髋关节伸展幅度较小(P = 0.008),且无显著的交互作用(P = 0.206)。在PAHD组中,报告疼痛的个体和报告无疼痛的个体之间的髋关节角度和活动度相似。这项研究的结果表明,髋骨关节炎患者常见的运动学改变在髋部疾病的连续过程中很早就存在,并且在患有PAHD的个体中也存在。行走时髋关节伸展减少不能用速度、结构限制或当前疼痛来解释。