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早期膝关节骨关节炎患者从站立到坐下任务期间下肢的生物力学分析。

Biomechanical analysis of lower limbs during stand-to-sit tasks in patients with early-stage knee osteoarthritis.

作者信息

Pan Jing, Huang Wenqin, Huang Zhiguan, Luan Jun, Zhang Xiaohui, Liao Bagen

机构信息

Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China.

School of Sports and Health, Guangzhou Sport University, Guangzhou, China.

出版信息

Front Bioeng Biotechnol. 2023 Dec 20;11:1330082. doi: 10.3389/fbioe.2023.1330082. eCollection 2023.

Abstract

Knee osteoarthritis (KOA) is a common degenerative disease among the older people that severely affects their daily life. Previous studies have confirmed that movement biomechanics are altered in patients with KOA during task performance. However, changes that occur in lower limb joints and muscles in the three planes during stand-to-sit (STS) tasks in patients with early-stage KOA are unclear. Of the 36 participants recruited in this study, 24 (8 males and 16 females) and 12 (4 males and 8 females) were added to the KOA and control groups, respectively. The Nexus Vicon motion capture system along with Delsys wireless surface electromyography devices and plantar pressure measurement mat was used to record test data. A Visual 3D software was used to process the data and calculate the biomechanical and electromyographic parameters during STS tasks. There was no significant difference in task duration between the two groups. Patients with KOA could perform a greater range of pelvic motion and smaller range of hip and knee joint motion with a lower maximum hip joint angular acceleration in the sagittal plane and greater knee and ankle joint motion in the coronal plane. There was no significant difference in the motion range in the horizontal plane. During the STS task, patients in the KOA group had a lower vertical ground reaction force (GRF) amplitude on the injured side but a higher integrated GRF on both sides than those in the control group. Moreover, patients with KOA demonstrated higher PERM and PABM of the lower limb joints and smaller knee PADM and ankle PEM. Additionally, maximum activation levels of GMed muscle, affected-side gluteus medius (GM), ST, rectus femoris (RF), and tibialis anterior (TA) muscles were lower in patients with KOA than in controls. Conversely, the activation level of biceps femoris (BF) was higher. Furthermore, the integral EMG values of GMed, GM, ST, VL, RF, vastus medialis VM, and TA muscles on the affected side were lower, except for the BF muscle, in patients with KOA. Compared with the participants in the control group, patients with early-stage KOA exhibited consistent changes in sEMG parameters and biomechanical alterations in the sagittal plane, as observed in previous studies. However, differences in parameters were observed in the coronal and transverse planes of these patients. The noninvasive analysis of the 3D parameters of the involved motion patterns may lead to the early detection of KOA.

摘要

膝关节骨关节炎(KOA)是老年人常见的退行性疾病,严重影响他们的日常生活。先前的研究证实,KOA患者在执行任务期间运动生物力学发生改变。然而,早期KOA患者在从站立到坐下(STS)任务期间下肢关节和肌肉在三个平面上发生的变化尚不清楚。在本研究招募的36名参与者中,分别有24名(8名男性和16名女性)和12名(4名男性和8名女性)被纳入KOA组和对照组。使用Nexus Vicon运动捕捉系统以及Delsys无线表面肌电图设备和足底压力测量垫来记录测试数据。使用Visual 3D软件处理数据并计算STS任务期间的生物力学和肌电图参数。两组之间的任务持续时间没有显著差异。KOA患者在矢状面可以进行更大范围的骨盆运动以及更小范围的髋关节和膝关节运动,髋关节最大角加速度较低,在冠状面膝关节和踝关节运动范围更大。在水平面的运动范围没有显著差异。在STS任务期间,KOA组患者患侧的垂直地面反作用力(GRF)幅度较低,但两侧的GRF积分高于对照组。此外,KOA患者下肢关节的PERM和PABM较高,膝关节PADM和踝关节PEM较小。此外,KOA患者患侧臀中肌(GMed)、臀中肌(GM)、半腱肌(ST)、股直肌(RF)和胫骨前肌(TA)的最大激活水平低于对照组。相反,股二头肌(BF)的激活水平较高。此外,除BF肌肉外,KOA患者患侧GMed、GM、ST、股外侧肌(VL)、RF、股内侧肌(VM)和TA肌肉的肌电图积分值较低。与对照组参与者相比,早期KOA患者如先前研究中所观察到的那样,在矢状面的表面肌电图参数和生物力学改变方面表现出一致的变化。然而,在这些患者的冠状面和横断面观察到参数差异。对相关运动模式的三维参数进行无创分析可能有助于KOA的早期检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d96/10763667/10a878e5519e/fbioe-11-1330082-g001.jpg

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