Zhang Li, Ma Rui, Li Hui, Wan Xianjie, Xu Peng, Zhu Aibin, Wei Pingping
Honghui Hospital, Xi'an Jiaotong University, Xi'an 710000, PR China.
Shaanxi Key Laboratory of Intelligent Robots, Institute of Robotics and Intelligent Systems, Xi'an Jiaotong University, Xi'an 710049, PR China.
Heliyon. 2024 Aug 26;10(17):e36931. doi: 10.1016/j.heliyon.2024.e36931. eCollection 2024 Sep 15.
This study aim to quantify the differences in knee biomechanics during gait between knee osteoarthritis (KOA) patients and healthy individuals.
Twenty KOA patients (4 males and 16 females, 66.2 ± 7.7 years) and twenty controls (16 males and 4 females, 64.8 ± 5.4 years) were recruited for gait test using the motion capture system and force-platform system. The spatiotemporal parameters, knee kinematics and kinetics, and tibiofemoral contact force (TFCF) were calculated using an improved musculoskeletal model.
KOA patients walked with reduced speed (48.6 %), stride length (32.9 %), stride height (33.0 %), time proportions of single-support phases (19.2 %), increased gait cycle time (31.0 %), time proportions of stance (8.5 %) and double-support phases (57.7-75.9 %). KOA patients had significant smaller peak flexion angle (29.1 %), flexion ROM (50.6 %) and peak flexion moment (90.2 %), greater peak adduction moment (KAM) (40.7 %), peak rotation moments (KRM) (50.0 %), KAM impulse (106.2 %) and KRM impulse (126.0 %). In proximodistal direction, greater medial TFCF impulse (238 %), total and medial first-peak TFCF (9.6 % and 15.2 %), and smaller lateral peak TFCF (33.3 %) and TFCF impulse (38.4 %) were found in KOA patients. Besides, significant differences were found in the total, medial and lateral peak TFCFs and TFCF impulses in mediolateral direction, and the medial and lateral TFCFs and TFCF impulses in anteroposterior direction.
Significant differences were found in the spatiotemporal parameters, knee kinematics and kinetics, and TFCF between the two groups. The results of this study have important implication for clinicians and rehabilitation physicians. These quantified biomechanical differences can provide data support for the personalized and quantified rehabilitation strategies, give suggestions for the exercises of KOA patients, help monitor disease, evaluate surgical treatment, and develop more effective preoperative planning and postoperative rehabilitation strategies.
本研究旨在量化膝骨关节炎(KOA)患者与健康个体在步态过程中膝关节生物力学的差异。
招募20名KOA患者(4名男性和16名女性,66.2±7.7岁)和20名对照者(16名男性和4名女性,64.8±5.4岁),使用运动捕捉系统和测力平台系统进行步态测试。使用改进的肌肉骨骼模型计算时空参数、膝关节运动学和动力学以及胫股接触力(TFCF)。
KOA患者行走速度降低(48.6%)、步长降低(32.9%)、步高降低(33.0%)、单支撑相时间比例降低(19.2%)、步态周期时间增加(31.0%)、站立相时间比例增加(8.5%)和双支撑相时间比例增加(57.7 - 75.9%)。KOA患者的最大屈曲角度显著减小(29.1%)、屈曲活动范围显著减小(50.6%)和最大屈曲力矩显著减小(90.2%),最大内收力矩(KAM)显著增大(40.7%)、最大旋转力矩(KRM)显著增大(50.0%)、KAM冲量显著增大(106.2%)和KRM冲量显著增大(126.0%)。在近远侧方向上,KOA患者的内侧TFCF冲量显著增大(238%)、总TFCF和内侧第一峰值TFCF显著增大(9.6%和15.2%),外侧峰值TFCF和TFCF冲量显著减小(33.3%和38.4%)。此外,在内外侧方向上总、内侧和外侧峰值TFCF以及TFCF冲量存在显著差异;在前后方向上内侧和外侧TFCF以及TFCF冲量也存在显著差异。
两组在时空参数、膝关节运动学和动力学以及TFCF方面存在显著差异。本研究结果对临床医生和康复医师具有重要意义。这些量化的生物力学差异可为个性化和量化的康复策略提供数据支持,为KOA患者的锻炼提供建议,有助于疾病监测、评估手术治疗效果,并制定更有效的术前规划和术后康复策略。