Althomali Omar
Department of Physiotherapy, University of Hail, College of Applied Medical Sciences, Hail, SAU.
Cureus. 2024 Sep 11;16(9):e69157. doi: 10.7759/cureus.69157. eCollection 2024 Sep.
Background and aim Sophisticated technologies in rehabilitation, such as three-dimensional gait analysis, allow for measuring kinematic and kinetic variables while performing activities. The first peak external knee adduction moment (EKAM) is considered an important outcome in individuals with knee osteoarthritis (OA) and has been shown to be affected by changes in foot position in static trials. The present study aimed to explore the variables in static trials that may lead to changes in the value of the EKAM while walking. Methods Twelve individuals participated in the current study and were asked to perform three static trials as follows: 20° toe-out, straight (0°), and 20° toe-in. The participants were asked to walk five trials (their own shoes and paces). The first peak EKAM was the main study outcome and was compared between conditions. Linear regression was used to investigate which variables in the static trials significantly predicted the magnitude of change in the EKAM while walking. Results The first peak EKAM significantly decreased by 8.2% while walking when changing the foot position in static trials from 20° toe-in to 20° toe-out. The magnitude of change in the EKAM was significantly (p<0.01) predicted by the magnitude of change in the knee joint frontal plane angle, shank transverse plane angle, ankle joint frontal plane angle, and hip joint frontal plane angle during static trials between 20° toe-in and 20° toe-out. The model was able to predict 94% of the variation in the EKAM due to changes in foot position during static trials. Conclusion Modifications in foot position during static trials led to a change in the first peak EKAM while walking. Researchers should focus on controlling the knee joint frontal plane angle, shank transverse plane angle, ankle joint frontal plane angle, and hip joint frontal plane angle during static trials when conducting longitudinal or crossover studies. Controlling these variables is necessary to reduce the likelihood of the EKAM being affected by static trials and to ensure that the EKAM changes in dynamic trials are not masked or increased by static trials.
背景与目的 康复领域的先进技术，如三维步态分析，能够在个体进行活动时测量运动学和动力学变量。首次出现的峰值膝关节外展力矩（EKAM）被视为膝关节骨关节炎（OA）患者的一项重要指标，并且在静态试验中已表明其会受到足部位置变化的影响。本研究旨在探究静态试验中可能导致步行时EKAM值发生变化的变量。方法 12名个体参与了本研究，并被要求进行如下三项静态试验：20°外八字、直立（0°）和20°内八字。参与者被要求穿着自己的鞋子以自己的步幅行走五次。首次出现的峰值EKAM是主要研究指标，并在不同条件之间进行比较。采用线性回归来研究静态试验中的哪些变量能够显著预测步行时EKAM的变化幅度。结果 当在静态试验中将足部位置从20°内八字改变为20°外八字时，步行时首次出现的峰值EKAM显著降低了8.2%。在20°内八字和20°外八字之间的静态试验中，膝关节额状面角度、小腿横断面角度、踝关节额状面角度和髋关节额状面角度的变化幅度能够显著（p<0.01）预测EKAM的变化幅度。该模型能够预测由于静态试验中足部位置变化导致的EKAM变化的94%。结论 静态试验中足部位置的改变会导致步行时首次出现的峰值EKAM发生变化。在进行纵向或交叉研究时，研究人员在静态试验期间应着重控制膝关节额状面角度、小腿横断面角度、踝关节额状面角度和髋关节额状面角度。控制这些变量对于降低EKAM受静态试验影响的可能性以及确保动态试验中EKAM的变化不被静态试验掩盖或增强是必要的。
