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与非患侧肢体和无症状对照相比,单侧膝骨关节炎患者的髋关节力量、股四头肌力量和动态平衡能力较低。

Hip strength, quadriceps strength and dynamic balance are lower in people with unilateral knee osteoarthritis compared to their non-affected limb and asymptomatic controls.

机构信息

Physical Therapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Australia.

School of Health and Rehabilitation Sciences, University of Queensland, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.

出版信息

Braz J Phys Ther. 2022 Nov-Dec;26(6):100467. doi: 10.1016/j.bjpt.2022.100467. Epub 2022 Dec 10.

Abstract

BACKGROUND

There is insufficient literature on multi-directional hip strength differences and dynamic balance between people with knee osteoarthritis (KOA) and healthy controls.

OBJECTIVE

In people with unilateral KOA, determine if hip/knee strength and dynamic balance differs (i) between sides, and (ii) compared to controls.

METHODS

Thirty-six participants (17 women; 65.5 ± 8.9 years) with unilateral KOA and 36 age- and sex-matched controls were included in a cross-sectional study. Outcomes included hip strength, quadriceps strength, and dynamic balance (three directions) during the Star Excursion Balance Test. Mixed ANOVA analysis was completed to investigate differences between Limbs and Groups. Mean differences (MD) and 95% confidence intervals (CI) were calculated.

RESULTS

Quadriceps and hip adduction strength were 16% (95%CI:10, 22) and 9% [95%CI: 3, 16) lower on the affected compared to non-affected side. Quadriceps and hip abduction, adduction, flexion, and extension strength (MD varying from 16%, 95%CI: 8, 25; to 34%, 95%CI: 17, 50) were weaker bilaterally in individuals with KOA compared to control. Posteromedial balance was 4% (95%CI: 2, 6) lower for affected compared to non-affected limbs in those with KOA and 13% (95%CI: 6, 21) lower in the affected limb compared to controls. Individuals with KOA had lower balance bilaterally in the anterior 11% (95%CI: 7, 15) and posterolateral 21% (95%CI: 13, 30) directions.

CONCLUSION

Hip/knee strength (especially in the sagittal and frontal planes) and dynamic balance are lower bilaterally in people with KOA compared to controls. Hip adduction strength is lower on the affected than non-affected limbs of people with KOA. Clinicians should consider that knee extension strength, hip strength, and dynamic balance are lower bilaterally in people with unilateral KOA.

摘要

背景

关于膝关节骨关节炎(KOA)患者与健康对照者之间髋关节力量的多向差异和动态平衡,相关文献还不够充分。

目的

在单侧 KOA 患者中,确定髋关节/膝关节力量和动态平衡是否存在差异:(i)在两侧之间,以及(ii)与对照组相比。

方法

本研究纳入了 36 名单侧 KOA 患者(17 名女性;65.5±8.9 岁)和 36 名年龄和性别匹配的健康对照者,采用横断面研究。研究结果包括在星形伸展平衡测试(Star Excursion Balance Test)中髋关节力量、股四头肌力量和三个方向的动态平衡。采用混合方差分析(Mixed ANOVA analysis)来探究肢体间和组间的差异。计算均值差值(MD)和 95%置信区间(CI)。

结果

与非患侧相比,患侧的股四头肌和髋关节内收力量分别低 16%(95%CI:10,22)和 9%(95%CI:3,16)。与对照组相比,KOA 患者的双侧髋关节外展、内收、内旋和外旋力量均较弱(MD 范围为 16%,95%CI:8,25;至 34%,95%CI:17,50)。与非患侧相比,KOA 患者的患侧后内侧平衡分别低 4%(95%CI:2,6),与对照组相比,患侧低 13%(95%CI:6,21)。KOA 患者双侧的前侧和后侧平衡分别低 11%(95%CI:7,15)和 21%(95%CI:13,30)。

结论

与对照组相比,KOA 患者的髋关节/膝关节力量(尤其是矢状面和额状面)和动态平衡均较低。与非患侧相比,KOA 患者的患侧髋关节内收力量较低。临床医生应注意,单侧 KOA 患者的患侧和健侧的膝关节伸肌力量、髋关节力量和动态平衡均较低。

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本文引用的文献

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