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印度人群原发性膝关节骨关节炎的步态分析与膝关节功能评分及其与疾病进展的相关性

Gait Analysis and Functional Knee Scores in Primary Knee Osteoarthritis and Their Correlation with Progression of the Disease in the Indian Population.

作者信息

Barai Nihar Kanti, Mittal Ravi, Ansari Mohammed Tahir, Kumar Venkatesan Sampath, Sai Krishna M L V, Gupta Manish, Pandey Shivam

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

出版信息

Indian J Orthop. 2024 Feb 16;58(4):424-432. doi: 10.1007/s43465-024-01103-9. eCollection 2024 Apr.

Abstract

INTRODUCTION

Osteoarthritis of the knee is a leading cause of disability and is a multi-factorial disease. Moreover, it is partly considered a mechanically driven disease in which higher abnormally disbursed forces play a prime role. With the progression of the disease, the gait function declines, so a comprehensive and objective evaluation of gait function would help in prognostic evaluation and management.

MATERIALS AND METHODS

This study included two groups: patients with primary knee osteoarthritis and a control group of healthy volunteers. Gait analysis and functional knee scores were evaluated for all the subjects. The KOOS score, temporal parameters excluding the step length, and spatial parameters excluding the stance phase percentage were evaluated for an individual as a whole. The KSS score, kinetic parameters, kinematic parameters, step length, and stance phase percentage were calculated for each knee separately. Each knee of the patient and controls was taken as 1 sample and categorized as per Kellgren-Lawrence score. An asymptomatic control group of subjects were included in group A. Symptomatic patients with KL grades 1, 2 were included in group M, and those with KL grades 3, 4 were included in group S. The kinetic and kinematic parameters and KSS score were compared among the three groups.

RESULTS

A total of 60 subjects were included of which 40 were patients and 20 were controls. In the control group, the age ranged from 22 to 48 years with a mean age of 28.6 years. In the patient group, the mean age was 60.3 years. Patients with knee osteoarthritis were significantly obese with slower walking speed, short stride length, longer stride time, and decreased cadence compared to the asymptomatic group. There was a significant difference in spatiotemporal parameters, functional scores, and kinetic and kinematic parameters among the groups.

CONCLUSION

Various spatiotemporal, kinetic, and kinematic parameters like peak knee flexion angle, abduction/adduction angle, peak knee adduction moment, range of knee flexion, peak knee flexion, and gait deviation index along with functional scores varied significantly with the progression of the disease.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s43465-024-01103-9.

摘要

引言

膝关节骨关节炎是导致残疾的主要原因,是一种多因素疾病。此外,它部分被认为是一种机械驱动性疾病,其中较高的异常分布力起主要作用。随着疾病的进展,步态功能下降,因此对步态功能进行全面客观的评估将有助于预后评估和管理。

材料与方法

本研究包括两组:原发性膝关节骨关节炎患者和健康志愿者对照组。对所有受试者进行步态分析和膝关节功能评分。对个体整体评估膝关节骨关节炎结局评分(KOOS)、不包括步长的时间参数以及不包括站立相百分比的空间参数。分别计算每个膝关节的膝关节协会评分(KSS)、动力学参数、运动学参数、步长和站立相百分比。将患者和对照组的每个膝关节作为1个样本,并根据凯尔格伦-劳伦斯评分进行分类。A组纳入无症状受试者对照组。M组纳入凯尔格伦-劳伦斯(KL)分级为1、2级的有症状患者,S组纳入KL分级为3、4级的患者。比较三组之间的动力学和运动学参数以及KSS评分。

结果

共纳入60名受试者,其中40名是患者,20名是对照组。对照组年龄在(22)至(48)岁之间,平均年龄为(28.6)岁。患者组平均年龄为(60.3)岁。与无症状组相比,膝关节骨关节炎患者明显肥胖,步行速度较慢,步长较短,步幅时间较长,步频降低。各组之间在时空参数、功能评分以及动力学和运动学参数方面存在显著差异。

结论

随着疾病进展,各种时空、动力学和运动学参数,如膝关节最大屈曲角度、外展/内收角度、膝关节最大内收力矩、膝关节屈曲范围、膝关节最大屈曲以及步态偏差指数,连同功能评分均有显著变化。

补充信息

网络版包含可在10.1007/s43465 - 024 - 01103 - 9获取的补充材料。

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