与平地行走相比，健康受试者在斜坡行走过程中的膝关节六自由度运动学。
The 6DOF knee kinematics of healthy subjects during sloped walking compared to level walking.
作者信息
Zeng Xiaolong, Xie Zhenyan, Zhong Guoqing, Chen Ying, Wen Baohong, Li Yixi, Ma Limin, Huang Wenhan, Yang Tao, Zhang Yu
机构信息
School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong, China; Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China.
Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China; Shantou Central Hospital, Shantou 515000, Guangdong, China.
出版信息
Gait Posture. 2022 Jun;95:198-203. doi: 10.1016/j.gaitpost.2022.05.004. Epub 2022 May 4.
BACKGROUND
Level Walking is a frequent functional movement during daily life. However, sloped walking is also common. Exploring 6DOF knee kinematics during sloped walking is important. It provides a reference for the rehabilitation, safety, and knee health of patients with knee diseases walking on sloped surfaces.
RESEARCH QUESTION
The study aimed to explore 6DOF knee kinematics characteristics during sloped walking compared to level walking. We hypothesized that tibial anteroposterior translation and flexion angle (the sagittal plane) were significantly different from those of level walking.
METHODS
One hundred young, healthy adults (50 males and 50 females) were recruited for this study. A three-dimensional gait analysis system was used to collect 6DOF knee kinematics during level and sloped walking. The slope was set to ± 15% when the sloped walking was performed.
RESULTS
Sloped walking mainly increased knee flexion angle (upslope, 2.5-26.2°, 1-100% gait cycle (GC), p < 0.05; downslope, 1.7-11.9°, 15-95% GC, p < 0.05) and anterior tibial translation (upslope, 0.7-4.1 mm, 3-54% GC & 0.6-2.1 mm, 80-94% GC; downslope, 1.0-2.2 mm, 21-69% GC) in the participants' knees. However, participants' other 4DOF knee kinematics during sloped walking were significantly different from those during level walking (p < 0.05). Participants had 'drastically changeable' knee kinematic alterations in the transverse and coronal plane (the other 4DOF knee kinematics) during sloped walking compared to level walking.
SIGNIFICANCE
Our results confirmed the hypothesis. Sloped walking significantly increased anterior tibial translation (in most GC) and flexion angle. These kinematic changes in healthy subjects should be evaluated and further explored for patients with knee diseases, such as anterior cruciate ligament deficiency. Our findings are meaningful for their rehabilitation or safety or knee health while walking on sloped surfaces. Our study may provide a pilot reference for the 6DOF knee kinematic exploration of sloped walking.
背景
平地行走是日常生活中常见的功能性活动。然而，斜坡行走也很普遍。探究斜坡行走过程中的六自由度膝关节运动学很重要。它为患有膝关节疾病的患者在斜坡表面行走时的康复、安全和膝关节健康提供参考。
研究问题
本研究旨在探究与平地行走相比，斜坡行走过程中的六自由度膝关节运动学特征。我们假设胫骨的前后平移和屈曲角度（矢状面）与平地行走时有显著差异。
方法
招募了100名年轻健康的成年人（50名男性和50名女性）参与本研究。使用三维步态分析系统收集平地和斜坡行走过程中的六自由度膝关节运动学数据。进行斜坡行走时，坡度设置为±15%。
结果
斜坡行走主要增加了参与者膝关节的屈曲角度（上坡时，2.5-26.2°，步态周期（GC）的1-100%，p<0.05；下坡时，1.7-11.9°，GC的15-95%，p<0.05）和胫骨向前平移（上坡时，0.7-4.1毫米，GC的3-54%以及0.6-2.1毫米，GC的80-94%；下坡时，1.0-2.2毫米，GC的21-69%）。然而，参与者在斜坡行走过程中的其他四自由度膝关节运动学与平地行走时显著不同（p<0.05）。与平地行走相比，参与者在斜坡行走过程中在横断面和冠状面（其他四自由度膝关节运动学）有“剧烈变化”的膝关节运动学改变。
意义
我们的结果证实了假设。斜坡行走显著增加了胫骨向前平移（在大多数GC中）和屈曲角度。对于患有膝关节疾病的患者，如前交叉韧带损伤患者，应评估并进一步探究健康受试者的这些运动学变化。我们的发现对于他们在斜坡表面行走时的康复、安全或膝关节健康具有重要意义。我们的研究可能为斜坡行走的六自由度膝关节运动学探究提供初步参考。
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