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膝关节骨关节炎与无膝关节骨关节炎老年人步态节律性和对称性的性别差异。

Sex differences in the regularity and symmetry of gait in older adults with and without knee osteoarthritis.

机构信息

Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Canada.

Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada.

出版信息

Gait Posture. 2022 Jun;95:192-197. doi: 10.1016/j.gaitpost.2022.04.023. Epub 2022 Apr 30.

Abstract

BACKGROUND

Three-dimensional (3D) motion measured at the lower back during walking can describe the regularity and symmetry of gait that may be related to osteoarthritis (OA) and functional status. However, gait speed and inherent sex differences, regardless of the presence of OA, may confound these measures. Therefore, there is a need to understand the effect of OA separately among males and females, without the confounding influence of gait speed.

OBJECTIVE

To investigate the difference in 3D gait regularity and symmetry measures between gait speed-matched males and females with and without knee OA.

METHOD

Gait regularity and symmetry were computed as autocorrelations of pelvic accelerations during treadmill walking in four groups of older adults: healthy asymptomatic females (AsymF; n = 44), healthy asymptomatic males (AsymM; n = 45), females diagnosed with knee OA (OAF; n = 44), and males diagnosed with knee OA (OAM; n = 45). Data were obtained from a larger research database, allowing for the matching of gait speed between groups. The main effect of OA, sex, and interaction effect between them was examined for the 3D gait regularity and symmetry measures at an alpha level of 0.05.

RESULTS

There was no main effect of OA on any variable, but there was a significant main effect of sex on mediolateral and anteroposterior gait regularity measures. Specifically, females demonstrated significantly greater gait regularity, most notably in the mediolateral directions compared to males.

CONCLUSION

Older adult females were found to display significantly greater mediolateral gait regularity as compared to males, regardless of the presence of OA. Further, this difference exists among matched gait speeds, suggesting it is not the result of gait speed. Overall, these results highlight the importance of sex-specific analyses and considering gait speed when examining gait acceleration patterns near the center of mass for both cross sectional and longitudinal gait assessments.

摘要

背景

在行走过程中测量下背部的三维(3D)运动可以描述步态的规律性和对称性,这可能与骨关节炎(OA)和功能状态有关。然而,无论是否存在 OA,步行速度和固有的性别差异都可能使这些测量结果复杂化。因此,需要在不考虑步态速度影响的情况下,分别了解男性和女性 OA 的影响。

目的

研究在匹配步行速度的情况下,有无膝 OA 的男性和女性之间 3D 步态规律性和对称性测量值的差异。

方法

在四个老年组的跑步机行走过程中,计算骨盆加速度的自相关作为步态规律性和对称性的指标:无症状健康女性(AsymF;n=44)、无症状健康男性(AsymM;n=45)、诊断为膝 OA 的女性(OAF;n=44)和诊断为膝 OA 的男性(OAM;n=45)。数据来自一个更大的研究数据库,允许在组间匹配步行速度。在 0.05 的 alpha 水平下,检验 OA、性别和它们之间的相互作用对 3D 步态规律性和对称性指标的主要影响。

结果

OA 对任何变量都没有主要影响,但性别对横向和前后向步态规律性测量值有显著的主要影响。具体而言,女性的步态规律性明显更大,尤其是在横向方向与男性相比。

结论

与男性相比,无论是否存在 OA,老年女性的横向步态规律性都明显更大。此外,这种差异存在于匹配的步行速度中,这表明它不是步行速度的结果。总体而言,这些结果强调了对性别特异性分析和考虑在检查质心附近的步态加速度模式时考虑步态速度的重要性,无论是在横断面还是纵向步态评估中。

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