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; Medical college, Shantou University, Shantou 515000, Guangdong, China.
Gait Posture. 2023 Mar;101:166-172. doi: 10.1016/j.gaitpost.2023.02.015. Epub 2023 Feb 26.
The walking knee kinematic results of generalized joint hypermobility (GJH) subjects were controversial in previous studies. We proposed that this could be related to the knee statuses of GJH subjects with/without knee hyperextension (KH) and assumed that there are significant sagittal knee kinematic differences between GJH subjects with/without KH during gait.
Do GJH subjects with KH exhibit significantly different kinematic characteristics than those without KH during walking?
35 GJH subjects without KH, 34 GJH subjects with KH, and 30 healthy controls were recruited in this study. A three-dimensional gait analysis system was used to record and compare the knee kinematics of the participants.
Significant walking knee kinematics differences were found between GJH subjects with/without KH during walking. GJH subjects without KH had greater flexion angles (4.7-6.0°, 24-53 % gait cycle (GC), p < 0.001; 5.1-6.1°, 65-77 % GC, p = 0.008) and anterior tibial translation (ATT) (3.3-4.1 mm, 0-4 % GC, p = 0.015; 3.8-4.3 mm, 91-100 % GC, p = 0.01) than those with KH. Compared to controls, GJH without KH exhibited increased ATT (4.0-5.7 mm, 0-26 % GC, p < 0.001; 5.1-6.7 mm, 78-100 % GC, p < 0.001), and range of motion of ATT (3.3 mm, p = 0.028) whereas GJH with KH only exhibited increased extension angle (6.9-7.3°, 62-66 % GC, p = 0.015) during walking.
The findings confirmed the hypothesis and suggested that GJH subjects without KH had more walking ATT and flexion angle asymmetries than those with KH. This may raise concerns about the differences in knee health and risk of knee diseases between GJH subjects with/without KH. However, further investigations should be done to explore the exact influence of walking ATT and flexion angle asymmetries in GJH subjects without KH.
先前的研究中,全身性关节过度活动(GJH)受试者的膝关节运动学结果存在争议。我们认为这可能与伴有/不伴有膝关节过伸(KH)的 GJH 受试者的膝关节状况有关,并假设在步态中伴有/不伴有 KH 的 GJH 受试者的膝关节矢状面运动学存在显著差异。
伴有 KH 的 GJH 受试者在行走时是否表现出与不伴有 KH 的 GJH 受试者明显不同的运动学特征?
本研究纳入了 35 名无 KH 的 GJH 受试者、34 名有 KH 的 GJH 受试者和 30 名健康对照者。使用三维步态分析系统记录和比较参与者的膝关节运动学。
行走时伴有/不伴有 KH 的 GJH 受试者的膝关节运动学存在显著差异。无 KH 的 GJH 受试者的膝关节屈曲角度更大(4.7-6.0°,24-53%步态周期(GC),p<0.001;5.1-6.1°,65-77% GC,p=0.008),前胫骨平移(ATT)更大(3.3-4.1mm,0-4% GC,p=0.015;3.8-4.3mm,91-100% GC,p=0.01)。与对照组相比,无 KH 的 GJH 受试者的 ATT 增加(4.0-5.7mm,0-26% GC,p<0.001;5.1-6.7mm,78-100% GC,p<0.001),ATT 运动范围增加(3.3mm,p=0.028),而伴有 KH 的 GJH 受试者仅在行走时伸展角度增加(6.9-7.3°,62-66% GC,p=0.015)。
这些发现证实了假设,并表明无 KH 的 GJH 受试者的 ATT 和膝关节屈曲角度不对称性大于伴有 KH 的 GJH 受试者。这可能引起对伴有/不伴有 KH 的 GJH 受试者的膝关节健康状况和膝关节疾病风险差异的关注。然而,应该进行进一步的研究来探讨无 KH 的 GJH 受试者的 ATT 和膝关节屈曲角度不对称性的确切影响。