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女性髋关节疼痛患者在峰值和整个步态周期中行走时运动学发生改变。

Females with hip pain walk with altered kinematics at peaks and throughout the gait cycle.

机构信息

Human Adaptation Lab, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Room 110, Boston, MA 02215, United States.

Newton-Wellesley Hospital, 2014 Washington St, Newton, MA 02462, United States.

出版信息

Clin Biomech (Bristol). 2024 Aug;118:106314. doi: 10.1016/j.clinbiomech.2024.106314. Epub 2024 Jul 22.

Abstract

BACKGROUND

Females with acetabular dysplasia and/or labral tears (hip pain) exhibit altered walking kinematics, with studies reporting mixed results in sagittal and frontal planes compared to pain-free controls, often conducting only discrete analyses and warranting further investigation. The objective of this study was to investigate discrete and continuous hip and pelvic kinematics between females with and without hip pain in two walking conditions.

METHODS

We collected kinematic walking data from 69 females (35 with hip pain, 34 controls) using motion capture and an instrumented treadmill in two conditions: preferred and fast (125% preferred). We used a general linear model and one-dimensional statistical parametric mapping to conduct discrete and continuous analyses comparing kinematics between groups, with and without adjustment for gait speed.

FINDINGS

The hip pain group walked with reduced peak hip extension (Preferred: P = .046, Cohen's d = 0.41; Fast: P = .028, d = 0.48) and greater peak anterior pelvic tilt (Preferred: P = .011, d = 0.57; Fast: P = .012, d = 0.58) compared to controls. From continuous analyses, the hip pain group walked with reduced hip extension during terminal stance (Fast: P = .040), greater anterior pelvic tilt throughout (Preferred: P = .007; Fast: P = .004), and greater contralateral pelvic drop (Preferred: P = .045) during midstance. Adjusting for speed slightly affected p-values, but significance was retained for all prior variables except pelvic drop.

INTERPRETATION

Kinematic differences between individuals with and without hip pain may provide insight into potential predisposing factors for hip pathology and/or compensations for pain or pathological processes. This work furthers understanding of altered movement patterns in individuals with hip pain and may inform physical therapy treatments.

摘要

背景

患有髋臼发育不良和/或盂唇撕裂(髋关节疼痛)的女性表现出改变的步行运动学特征,与无疼痛对照组相比,在矢状面和额状面的研究结果存在差异,这些研究通常仅进行离散分析,需要进一步研究。本研究的目的是在两种步行条件下,研究有和无髋关节疼痛的女性之间髋关节和骨盆运动学的离散和连续变化。

方法

我们使用运动捕捉和仪器化跑步机从 69 名女性(35 名有髋关节疼痛,34 名对照组)中收集了步行运动学数据,在两种条件下:首选和快速(首选的 125%)。我们使用一般线性模型和一维统计参数映射,在不调整和调整步行速度的情况下,比较组间的运动学离散和连续分析。

发现

与对照组相比,髋关节疼痛组在首选(P=0.046,Cohen's d=0.41)和快速(P=0.028,d=0.48)时的髋关节伸展峰值较小,而骨盆前倾峰值较大。从连续分析来看,髋关节疼痛组在末期支撑时髋关节伸展减少(Fast:P=0.040),整个过程中骨盆前倾较大(Preferred:P=0.007;Fast:P=0.004),中期对侧骨盆下降较大(Preferred:P=0.045)。调整速度后,p 值略有影响,但除骨盆下降外,所有先前变量的显著性均保留。

解释

有和无髋关节疼痛的个体之间的运动学差异可能提供对髋关节病理的潜在易患因素和/或对疼痛或病理过程的补偿的深入了解。这项工作进一步了解了髋关节疼痛患者的运动模式改变,并可能为物理治疗提供信息。

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Effect of simulated changes in pelvic tilt on hip joint forces.模拟骨盆倾斜变化对髋关节力的影响。
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