CIRRIS, Wilfrid-Hamel 525, G1M 2S8, Québec, Canada.
CIRRIS, Wilfrid-Hamel 525, G1M 2S8, Québec, Canada.
J Biomech. 2021 Dec 2;129:110740. doi: 10.1016/j.jbiomech.2021.110740. Epub 2021 Sep 11.
Gait retraining as a non-invasive prospective approach to restore mechanical loading at the knee joint and slowing down knee osteoarthritis (OA) progression shows great promise. However, the impact of gait modifications such as an increase in foot progression angle (FPA) or lateral trunk lean (LTL) on the ankle and hip is not yet well understood. Thus, the goal of this study is to provide insight on the impact of FPA and LTL on the sagittal and frontal external moments at the ankle and hip of healthy participants. We hypothesize that there is an optimum, for which an increase in FPA and/or LTL minimize the knee adduction moment (KAM) without increasing significantly the frontal and sagittal external moments at the ankle and hip during gait. To test this hypothesis, 23 participants performed walking trials with modified FPA and/or LTL angles following a real-time visual feedback. The hypothesis was not confirmed and while not all the gait modifications performed by the participants in this study reduced the KAM, they significantly increased the sagittal moment at the ankle and the frontal moment at the hip. This study highlights the importance to consider the biomechanical consequences of gait modifications on the ankle and hip before considering a clinical application of gait retraining approaches.
步态再训练作为一种非侵入性的前瞻性方法，可恢复膝关节的机械负荷，并减缓膝关节骨关节炎（OA）的进展，具有很大的潜力。然而，诸如增加足进距角（FPA）或横向躯干倾斜（LTL）等步态改变对踝关节和髋关节的影响尚未得到很好的理解。因此，本研究的目的是提供关于 FPA 和 LTL 对健康参与者踝关节和髋关节矢状面和额状面外力矩影响的见解。我们假设存在一个最佳角度，在此角度下，增加 FPA 和/或 LTL 可以最小化膝关节内收力矩（KAM），而在步态中不会显著增加踝关节和髋关节的额状面和矢状面外力矩。为了验证这一假设，23 名参与者在实时视觉反馈下进行了具有修改后的 FPA 和/或 LTL 角度的行走试验。该假设未得到证实，虽然本研究中所有参与者进行的步态改变都没有降低 KAM，但它们显著增加了踝关节的矢状面力矩和髋关节的额状面力矩。这项研究强调了在考虑步态再训练方法的临床应用之前，有必要考虑步态改变对踝关节和髋关节的生物力学后果。
