Kim Yongwook
Department of Physical Therapy, College of Medical Sciences, Jeonju University, 303 Cheonjam-ro, Wansan-gu, Jeonju 55069, Republic of Korea.
Bioengineering (Basel). 2024 Jul 9;11(7):696. doi: 10.3390/bioengineering11070696.
The aim of the study was to verify the effects of foot progression angle (FPA) modification during walking on the internal moments of the ankle and knee joints in individuals with knee osteoarthritis (OA). Biomechanical changes such as increased knee adduction moment (KAM) during walking are known to be involved in the development and severity of knee OA. Although various FPA modifications during gait have been applied to reduce peak KAM, few studies have investigated the effects of applying toe-in or toe-out walking modifications for knee OA on peak KAM and three-dimensional (3D) moments of the ankle joint. Kinetic moment variables were acquired from 35 individuals with medial knee compartment OA. A 3D motion analysis system and two force platforms were used to acquire KAM and 3D moments of both ankle joints during gait. Visual3D was used to obtain final moment data for statistical processing. Repeated-measures analysis of variance with Bonferroni adjustment was used to compare kinetic and kinematic values for each FPA walking condition. There was a significant decrease ( < 0.01) in first peak KAM when walking with an internal rotation foot position compared to normal foot position walking. Also, there was a significant decrease ( < 0.01) in second peak KAM when walking with an external rotation foot position compared to normal foot position walking. Compared to a normal foot position, peak ankle inversion moment of the external rotation foot position walking showed a significant decrease ( < 0.05). There were no interactive effects between FPA condition and limb sides for any KAM values ( > 0.05). The results showed no significant increase in the ankle joint moment value during gait for FPA modification conditions. Thus, the clinical implications of this study suggest that modification of the FPA in patients with OA to reduce KAM does not negatively impact the 3D ankle moments.
本研究的目的是验证在行走过程中改变足前进角（FPA）对膝骨关节炎（OA）患者踝关节和膝关节内力矩的影响。已知行走过程中诸如膝关节内收力矩（KAM）增加等生物力学变化与膝OA的发展和严重程度有关。尽管在步态中应用了各种FPA改变以降低KAM峰值，但很少有研究调查对膝OA应用内八字或外八字行走改变对KAM峰值和踝关节三维（3D）力矩的影响。从35名内侧膝关节间隙OA患者获取动力学力矩变量。使用3D运动分析系统和两个测力平台在步态期间获取KAM和两个踝关节的3D力矩。使用Visual3D获得最终力矩数据用于统计处理。采用Bonferroni校正的重复测量方差分析来比较每种FPA行走条件下的动力学和运动学值。与正常足部位置行走相比，内旋足部位置行走时首次KAM峰值显著降低（<0.01）。此外，与正常足部位置行走相比，外旋足部位置行走时第二次KAM峰值显著降低（<0.01）。与正常足部位置相比，外旋足部位置行走时踝关节内翻力矩峰值显著降低（<0.05）。对于任何KAM值，FPA条件和肢体侧之间均无交互作用（>0.05）。结果表明，FPA改变条件下步态期间踝关节力矩值无显著增加。因此，本研究的临床意义表明，OA患者中改变FPA以降低KAM不会对3D踝关节力矩产生负面影响。
