Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands.
Clin Biomech (Bristol). 2023 Jul;107:106028. doi: 10.1016/j.clinbiomech.2023.106028. Epub 2023 Jun 10.
Due to anatomical deviations, assumptions of the conventional calibration method for gait analysis may be violated in individuals with rotational deformities of the femur. Functional calibration methods were compared with conventional methods in this group for 1) localization of the hip joint center and orientation of the knee axis, and 2) gait kinematics.
Twenty-four adolescents with idiopathic rotational deformity of the femur underwent gait analysis and a CT scan. During standing, distance between hip joint centers and knee axis orientation were compared between calibration methods, with CT serving as reference for hip joint center estimation. Gait kinematics were compared using statistical parametric mapping.
The conventional calibration method estimated the hip joint center closer to the CT reference (4±12 mm more lateral) than the functional calibration method (26 ± 20 mm more lateral). Orientation of the knee joint axis was 2.6° less internal in the functional calibration method. During gait, statistical parametric mapping revealed significantly more hip flexion, less external hip rotation during the swing phase, less knee varus-valgus motion, and larger knee flexion angles when applying the functional method.
Functional calibration methods were less accurate in determining the hip joint center location than the conventional calibration method and resulted in a knee joint axis that was less internally rotated. Importantly, there was less knee joint angle crosstalk during gait when using the functional method. Although differences between methods on gait kinematics were within clinically acceptable limits for the sagittal plane, relatively larger differences on transversal hip kinematics may hold clinical importance.
由于解剖学上的偏差，对于股骨旋转畸形的患者，传统步态分析校准方法的假设可能会被违反。本研究比较了功能校准方法与传统方法在以下方面的差异：1）髋关节中心定位和膝关节轴方向，以及 2）步态运动学。
24 名特发性股骨旋转畸形的青少年接受了步态分析和 CT 扫描。在站立时，比较了两种校准方法的髋关节中心之间的距离和膝关节轴的方向，CT 扫描结果被用作髋关节中心的参考。使用统计参数映射法比较步态运动学。
与功能校准方法相比（更外侧 26±20 毫米），传统校准方法估计的髋关节中心更接近 CT 参考值（更外侧 4±12 毫米）。膝关节轴的方向在功能校准方法中内旋减少 2.6°。在步态中，应用功能方法时，统计参数映射显示髋关节屈曲角度明显增加，摆动期外展髋关节旋转角度减少，膝关节内翻-外翻运动减少，膝关节屈曲角度增大。
与传统校准方法相比，功能校准方法在确定髋关节中心位置的准确性较差，导致膝关节轴的内旋角度较小。重要的是，在使用功能方法时，膝关节角度的交叉较少。尽管两种方法在矢状面上的步态运动学差异在临床可接受范围内，但在横向髋关节运动学上的差异可能具有临床意义。
