髋关节撞击综合征关节镜术后个体在进行前向跨步任务时，临床医生定义的不稳定性的生物力学测量。
Biomechanical measures of clinician-defined unsteadiness during a forward stepdown task in individuals post-arthroscopy for femoroacetabular impingement syndrome.
机构信息
Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States; Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10(th) Avenue, Columbus, OH 43210, United States.
Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH 43202, United States; Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10(th) Avenue, Columbus, OH 43210, United States; Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W. 10(th) Avenue, Columbus, OH 43210, United States.
出版信息
Clin Biomech (Bristol). 2022 Mar;93:105586. doi: 10.1016/j.clinbiomech.2022.105586. Epub 2022 Jan 29.
BACKGROUND
Patients with femoroacetabular impingement syndrome can present with aberrant movement patterns including unsteady balance. Balance training is included in rehabilitation after hip arthroscopy and may improve quality of movement; however, specific biomechanical measures associated with clinician-defined balance impairments are unknown. We aimed to understand these associations as they may inform targeted rehabilitative interventions.
METHODS
The forward stepdown is a clinical test used to evaluate movement quality, including balance. 23 individuals at least one-year post-arthroscopy for femoroacetabular impingement syndrome and 15 healthy comparisons performed the forward stepdown, recorded by 3-dimensional motion capture and 2-dimensional video. Three physical therapists graded the 2-dimensional video for steadiness. Two-way analyses of variance were used to evaluate the interaction of group (post-arthroscopy/healthy comparison) by steadiness (steady/unsteady), for center of pressure medial-lateral excursion, center of pressure path length, and lateral trunk, pelvis, and lower extremity joint excursions.
FINDINGS
Six (26.1%) participants post-arthroscopy and five (33.3%) healthy comparisons were categorized as unsteady. The odds of being categorized as unsteady were not greater for participants post-arthroscopy (P = 0.72). There were no significant interactions; however, participants with clinician-defined unsteady balance, regardless of group, had significantly greater frontal plane trunk excursion, greater hip excursion, and greater center of pressure path length than those with steady balance (P ≤ 0.006).
INTERPRETATION
The odds of being categorized as unsteady were not greater for individuals post-arthroscopy for femoroacetabular impingement syndrome. Clinician-defined unsteadiness was associated with greater frontal plane trunk and hip motion which may be rehabilitation targets to improve balance during a dynamic single-leg task.
背景
患有股骨髋臼撞击综合征的患者可能会出现异常运动模式，包括不稳定的平衡。髋关节镜术后康复中包括平衡训练，这可能会改善运动质量；但是，与临床医生定义的平衡障碍相关的具体生物力学指标尚不清楚。我们旨在了解这些关联，因为它们可能为有针对性的康复干预提供信息。
方法
前向跨步是一种用于评估运动质量（包括平衡）的临床测试。23 名至少在髋关节镜术后一年的股骨髋臼撞击综合征患者和 15 名健康对照者进行了前向跨步测试，测试过程由三维运动捕捉和二维视频记录。三名物理治疗师对二维视频进行了稳定性评分。使用双向方差分析评估了组（髋关节镜术后/健康对照组）与稳定性（稳定/不稳定）之间的相互作用，用于评估中心压力的横向偏移、中心压力路径长度以及横向躯干、骨盆和下肢关节的偏移。
结果
6 名（26.1%）髋关节镜术后患者和 5 名（33.3%）健康对照组被归类为不稳定。髋关节镜术后患者被归类为不稳定的可能性没有更大（P=0.72）。没有显著的相互作用；但是，无论组别如何，临床医生定义为不稳定的患者在额状面躯干偏移、髋关节偏移和中心压力路径长度方面均显著大于稳定的患者（P≤0.006）。
解释
髋关节镜术后股骨髋臼撞击综合征患者被归类为不稳定的可能性没有更大。临床医生定义的不稳定与更大的额状面躯干和髋关节运动有关，这可能是改善动态单腿任务中平衡的康复目标。
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