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健康老年人和髋骨关节炎患者在直线行走和90°转弯时的活动能力需求及关节负荷

Mobility Requirements and Joint Loading during Straight Walking and 90° Turns in Healthy Older People and Those with Hip Osteoarthritis.

作者信息

Steingrebe Hannah, Sell Stefan, Stein Thorsten

机构信息

Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany.

Joint Center Black Forest, Hospital Neuenbuerg, 75305 Neuenbuerg, Germany.

出版信息

J Clin Med. 2024 Aug 25;13(17):5021. doi: 10.3390/jcm13175021.

Abstract

: Hip mobility and joint loading in hip osteoarthritis (HOA) patients are mostly assessed during straight walking. Yet, mobility limitations in the frontal and transverse planes are rarely found during this task in subjects with mild-to-moderate symptoms. Turning movements are frequently encountered during everyday life and might require larger hip mobility compared to straight walking, especially in the frontal and transverse planes. Thus, hip mobility and hip loading during straight walking and 90° turns in persons with HOA and healthy older adults were compared in this study. : A retrospective analysis was conducted on 21 subjects with mild-to-moderate HOA and 21 healthy controls. Hip angles and moments were assessed during straight walking and 90° step and spin turns. Gait analysis was conducted using a motion capture system and a force plate. Group and movement task differences were assessed with a mixed-model ANOVA. : Peak abduction and adduction angles were largest during the step and spin turn, respectively, as were the group differences between HOA subjects and healthy subjects. Both turns require a greater transverse hip range of motion compared to straight walking. Limitations in transverse hip mobility in the HOA group were especially prominent during the step turn. Both turns cause higher joint moments than straight walking. : The additional inclusion of 90° step and spin turns into gait analysis can enhance early identification of hip mobility limitations in the frontal and transverse planes in subjects with mild-to-moderate hip osteoarthritis. Early diagnosis is crucial for the timely application of conservative treatment strategies.

摘要

髋骨关节炎(HOA)患者的髋关节活动度和关节负荷大多在直线行走时进行评估。然而,在轻度至中度症状的受试者中,在此任务期间很少发现额面和横断面的活动受限。在日常生活中经常会遇到转身动作,与直线行走相比,可能需要更大的髋关节活动度,尤其是在额面和横断面。因此,本研究比较了HOA患者和健康老年人在直线行走和90°转弯时的髋关节活动度和髋关节负荷。

对21名轻度至中度HOA患者和21名健康对照者进行了回顾性分析。在直线行走、90°步转和自旋转期间评估髋关节角度和力矩。使用运动捕捉系统和测力板进行步态分析。采用混合模型方差分析评估组间和运动任务差异。

外展和内收峰值角度分别在步转和自旋转时最大,HOA受试者与健康受试者之间的组间差异也是如此。与直线行走相比,两种转弯都需要更大的髋关节横向活动范围。HOA组在步转时髋关节横向活动度的限制尤为突出。两种转弯都比直线行走产生更高的关节力矩。

在步态分析中额外纳入90°步转和自旋转,可以增强对轻度至中度髋骨关节炎患者额面和横断面髋关节活动度限制的早期识别。早期诊断对于及时应用保守治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4742/11396374/76696cdb5261/jcm-13-05021-g001.jpg

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