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膝关节骨关节炎患者中与僵硬步态相关的因素。

Factors associated with stiff knee gait in patients with knee osteoarthritis.

作者信息

Endo Naoto, Aoyama Toshiyuki, Yamamoto Satoshi, Ishibashi Kiyoshige, Ishii Daisuke, Kohno Yutaka

机构信息

Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki, 300-0394, Japan.

Yumemino Orthopedic Clinic, 1-5-3, Yumemino, Toride-shi, Ibaraki, 302-0039, Japan.

出版信息

J Orthop. 2024 Nov 22;64:81-85. doi: 10.1016/j.jor.2024.11.017. eCollection 2025 Jun.

Abstract

BACKGROUND

Stiff knee gait (SKG) is a common gait pattern in patients with knee osteoarthritis (KOA), characterized by reduced knee flexion excursion during gait. SKG can accelerate KOA progression; however, its underlying mechanisms and associated factors remain unclear. This study aimed to provide preliminary evidence on SKG-associated factors in patients with KOA.

METHODS

A pilot cross-sectional study was conducted at a single facility, including 21 patients with KOA undergoing rehabilitation. Knee flexion excursion during gait was assessed using a posture estimation library, classifying participants into SKG+ and SKG-. Evaluations covered pain intensity, muscle strength, knee range of motion (ROM), KOA severity, gait speed, fall efficacy, and health-related quality of life (QOL). Results were compared between groups to identify factors associated with SKG, and significant differences were analyzed for correlations with knee flexion excursion.

RESULTS

Among the 21 participants, 9 and 12 were in the SKG+ and SKG- groups, respectively. Significant differences were observed between the groups in pain intensity, quadriceps muscle strength, knee flexion ROM, and Western Ontario and McMaster Universities osteoarthritis index functional and total scores. Correlation analysis revealed that knee flexion excursion was moderately negatively correlated with pain intensity, moderately positively correlated with quadriceps muscle strength, and strongly positively correlated with knee flexion ROM.

CONCLUSION

This study suggests that SKG in patients with KOA is associated with greater pain intensity, reduced quadriceps muscle strength, and decreased knee ROM. SKG may also negatively affect QOL. These preliminary findings indicate that targeted interventions addressing these factors could prevent and improve SKG.

摘要

背景

僵硬膝步态(SKG)是膝骨关节炎(KOA)患者常见的步态模式,其特征是步态中膝关节屈曲幅度减小。SKG会加速KOA的进展;然而,其潜在机制和相关因素仍不清楚。本研究旨在为KOA患者中与SKG相关的因素提供初步证据。

方法

在单一机构进行了一项前瞻性横断面研究,纳入21例正在接受康复治疗的KOA患者。使用姿势估计库评估步态中的膝关节屈曲幅度,将参与者分为SKG+组和SKG-组。评估内容包括疼痛强度、肌肉力量、膝关节活动范围(ROM)、KOA严重程度、步态速度、跌倒效能和健康相关生活质量(QOL)。比较两组结果以确定与SKG相关的因素,并分析显著差异与膝关节屈曲幅度的相关性。

结果

21名参与者中,SKG+组和SKG-组分别有9名和12名。两组在疼痛强度、股四头肌力量、膝关节屈曲ROM以及西安大略和麦克马斯特大学骨关节炎指数功能和总分方面存在显著差异。相关分析显示,膝关节屈曲幅度与疼痛强度呈中度负相关,与股四头肌力量呈中度正相关,与膝关节屈曲ROM呈强正相关。

结论

本研究表明,KOA患者的SKG与更大的疼痛强度、股四头肌力量降低和膝关节ROM减小有关。SKG也可能对QOL产生负面影响。这些初步发现表明,针对这些因素的靶向干预措施可以预防和改善SKG。

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