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关节间协调可变性与膝关节骨关节炎患者的疼痛严重程度和关节负荷有关。

Inter-joint coordination variability is associated with pain severity and joint loading in persons with knee osteoarthritis.

机构信息

Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA.

Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, Missouri, USA.

出版信息

J Orthop Res. 2023 Dec;41(12):2610-2616. doi: 10.1002/jor.25592. Epub 2023 May 12.


DOI:10.1002/jor.25592
PMID:37132504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10622325/
Abstract

As the lower extremity is a linked-joint system, the contribution of movements at the hip and ankle, in addition to the knee, to gait patterns should be considered for persons with knee osteoarthritis (OA). However, the relationships of joint coordination variability to OA symptoms, particularly knee pain, and joint loading is unknown. The purpose of this study was to determine the relationship of joint coordination variability to knee pain severity and joint loading in persons with knee OA. Thirty-four participants with knee OA underwent gait analysis. Vector coding was used to assess coordination variability during the early, mid, and late stance phase. Hip-knee coupling angle variability (CAV) during midstance was associated with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain (r = -0.50, p = 0.002) and Visual Analog Scale pain (r = 0.36, p = 0.04). Knee-ankle CAV during midstance was associated with KOOS pain (r = -0.34, p = 0.05). Hip-knee CAV during early and midstance were associated with knee flexion moment (KFM) impulses (r = -0.46, p = 0.01). Knee-ankle CAV during early and midstance were associated with peak KFM (r = -0.51, p < 0.01; r = -0.70, p < 0.01). Moreover, knee-ankle CAV during early, mid, and late stance phase were associated with KFM impulses (r = -0.53, p < 0.01; r = -0.70, p < 0.01; r = -0.54, p < 0.01). These findings suggest that joint coordination variability may be a factor that influences pain and knee joint loading in persons with knee OA. Statement of Clinical Significance: Movement coordination of the hip, knee, and ankle should be considered in the clinical management and future research related to knee OA.

摘要

由于下肢是一个连接关节的系统,因此除了膝关节之外,还应考虑髋关节和踝关节的运动对膝骨关节炎(OA)患者步态模式的贡献。然而,关节协调可变性与 OA 症状(尤其是膝关节疼痛)和关节负荷之间的关系尚不清楚。本研究的目的是确定膝关节 OA 患者关节协调可变性与膝关节疼痛严重程度和关节负荷之间的关系。34 名膝关节 OA 患者接受了步态分析。矢量编码用于评估早期、中期和晚期支撑阶段的协调可变性。中期的髋关节-膝关节耦合角度可变性(CAV)与膝关节损伤和骨关节炎结果评分(KOOS)疼痛(r=-0.50,p=0.002)和视觉模拟量表疼痛(r=0.36,p=0.04)相关。中期的膝关节-踝关节 CAV 与 KOOS 疼痛相关(r=-0.34,p=0.05)。中期和早期的髋关节-膝关节 CAV 与膝关节屈曲力矩(KFM)脉冲相关(r=-0.46,p=0.01)。中期和早期的膝关节-踝关节 CAV 与峰值 KFM 相关(r=-0.51,p<0.01;r=-0.70,p<0.01)。此外,中期、晚期和早期的膝关节-踝关节 CAV 与 KFM 脉冲相关(r=-0.53,p<0.01;r=-0.70,p<0.01;r=-0.54,p<0.01)。这些发现表明,关节协调可变性可能是影响膝关节 OA 患者疼痛和膝关节负荷的一个因素。临床意义声明:在与膝关节 OA 相关的临床管理和未来研究中,应考虑髋关节、膝关节和踝关节的运动协调性。

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本文引用的文献

[1]
Reducing knee pain and loading with a gait retraining program for individuals with knee osteoarthritis: Protocol for a randomized feasibility trial.

Osteoarthr Cartil Open. 2020-9-3

[2]
Hip-Knee Joint Coordination Patterns are Associated With Patellofemoral Joint Cartilage Composition in Patients With Anterior Cruciate Ligament Reconstruction.

J Appl Biomech. 2022-2-1

[3]
Kinematic and Coordination Variability in Individuals With Acute and Chronic Patellofemoral Pain.

J Appl Biomech. 2021-10-1

[4]
Stable Coordination Variability in Overground Walking and Running at Preferred and Fixed Speeds.

J Appl Biomech. 2021-8-1

[5]
Knee loading in OA subjects is correlated to flexion and adduction moments and to contact point locations.

Sci Rep. 2021-4-21

[6]
Effects of knee osteoarthritis severity on inter-joint coordination and gait variability as measured by hip-knee cyclograms.

Sci Rep. 2021-1-19

[7]
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Front Bioeng Biotechnol. 2020-9-21

[8]
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Adv Orthop. 2019-3-24

[9]
Knee pain as a predictor of structural progression over 4 years: data from the Osteoarthritis Initiative, a prospective cohort study.

Arthritis Res Ther. 2018-11-6

[10]
Asymptomatic and symptomatic individuals with the same radiographic evidence of knee osteoarthritis walk with different knee moments and muscle activity.

J Orthop Res. 2017-8

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