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疼痛检测问卷和疼痛灾难化量表影响膝骨关节炎患者的步态模式。

Pain detect questionnaire and pain catastrophizing scale affect gait pattern in patients with knee osteoarthritis.

作者信息

Harato Kengo, Iwama Yu, Kaneda Kazuya, Kobayashi Shu, Niki Yasuo, Nagura Takeo

机构信息

Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

出版信息

J Exp Orthop. 2022 Jun 7;9(1):52. doi: 10.1186/s40634-022-00492-w.

Abstract

PURPOSE

Although pain phenotype affects clinical score in patients with knee osteoarthritis (OA), little information has been available on the relationship between pain phenotype and gait analysis. The purpose was to investigate the relationship between pain phenotype and gait parameters.  METHODS: A total of 34 patients (24 females and 10 males) with end-stage medial compartmental knee OA participated. All the patients were evaluated based on pain detect questionnaire (PD-Q) and pain catastrophizing scale (PCS). They were divided into two categories: Group Low (PD-Q score ≤ 12) and Group High (PD-Q score > 12), PCS + (PCS ≥ 23) and PCS- (PCS < 23). Gait analysis was performed using three-dimensional motion analysis system. Statistical analysis was done to compare gait parameters between groups for each allocation of PD-Q or PCS, separately.  RESULTS: Peak vertical ground reaction forces in Group Low and High were 0.99 ± 0.054 and 0.82 ± 0.17, respectively (P = 0.015). Peak knee adduction moments in Group Low and High were 0.70 ± 0.19 and 0.39 ± 0.14, respectively (P = 0.0022). For PCS allocation, knee extension limitation during mid-stance during gait were significantly larger in PCS- (P = 0.038).

CONCLUSIONS

Patients with high PD-Q score had atypical gait pattern with smaller peak vertical ground reaction force and knee adduction moment, compared to patients with low PD-Q score. Moreover, patient with low PCS had different gait pattern in extension limitation, compared to those with high PCS. PD-Q and PCS would affect gait pattern in patients with knee OA.

LEVEL OF EVIDENCE

III.

摘要

目的

尽管疼痛表型会影响膝骨关节炎(OA)患者的临床评分,但关于疼痛表型与步态分析之间的关系,目前所知甚少。本研究旨在探讨疼痛表型与步态参数之间的关系。方法:共有34例终末期内侧间室膝OA患者(24例女性,10例男性)参与研究。所有患者均基于疼痛检测问卷(PD-Q)和疼痛灾难化量表(PCS)进行评估。他们被分为两类:低分组(PD-Q评分≤12)和高分组(PD-Q评分>12),PCS+组(PCS≥23)和PCS-组(PCS<23)。使用三维运动分析系统进行步态分析。分别针对PD-Q或PCS的每种分类,对组间步态参数进行统计学分析以作比较。结果:低分组和高分组的垂直地面反作用力峰值分别为0.99±0.054和0.82±0.17(P = 0.015)。低分组和高分组的膝关节内收力矩峰值分别为0.70±0.19和0.39±0.14(P = 0.0022)。对于PCS分类,步态中支撑中期的膝关节伸展受限在PCS-组中显著更大(P = 0.038)。结论:与PD-Q评分低的患者相比,PD-Q评分高的患者具有非典型步态模式,垂直地面反作用力峰值和膝关节内收力矩较小。此外,与PCS高的患者相比,PCS低的患者在伸展受限方面具有不同的步态模式。PD-Q和PCS会影响膝OA患者的步态模式。证据等级:III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dc3/9170844/b7b1ee24a3f6/40634_2022_492_Fig1_HTML.jpg

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