Chan Daisy O M, Subasinghe Arachchige Ransi S S, Wang Sizhong, Chan Peter P K, Cheung Roy T H
Physiotherapy Department, Princess Margaret Hospital, Lai Chi Kok, Hong Kong.
School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
Sci Rep. 2024 Dec 28;14(1):30754. doi: 10.1038/s41598-024-80423-0.
Given the higher fall risk and the fatal sequelae of falls on stairs, it is worthwhile to investigate the mechanism of dynamic balance control in individuals with knee osteoarthritis during stair negotiation. Whole-body angular momentum ([Formula: see text]) is widely used as a surrogate to reflect dynamic balance and failure to constrain [Formula: see text] may increase the fall risk. This study aimed to compare the range of [Formula: see text] between people with and without knee osteoarthritis during stair ascent and descent. Seven participants with symptomatic knee osteoarthritis and eight asymptomatic controls were instructed to ascend and descend an instrumented staircase at a fixed cadence. Kinematic and kinetic data were collected and range of [Formula: see text] in sagittal, frontal, and transverse planes were computed. The knee osteoarthritis group exhibited greater [Formula: see text] in the sagittal plane during both stair ascent (P = 0.005, Cohen's d = 1.7) and descent (P = 0.020, Cohen's d = 1.3) as well as in the transverse plane during stair descent (P = 0.015, Cohen's d = 1.3), than the control group. These observations may be explained by greater hip flexion (P < 0.05, Cohen's d > 1.12) and reduced knee flexion moment (P < 0.001, Cohen's d<-2.77) during stair ascent and descent, and decreased foot progression angle (P = 0.038, Cohen's d=-1.2) during stair descent, in individuals with knee osteoarthritis. No significant difference in frontal plane [Formula: see text] was found between the two groups (P > 0.05). Individuals with knee osteoarthritis exhibited greater whole-body angular momentum during stair negotiation when compared to asymptomatic controls. Our findings may provide mechanistic rationale for a greater fall risk among people with knee osteoarthritis.
鉴于楼梯上跌倒风险较高且跌倒会导致致命后果，研究膝关节骨关节炎患者在上下楼梯过程中的动态平衡控制机制是很有价值的。全身角动量（[公式：见原文]）被广泛用作反映动态平衡的指标，无法控制[公式：见原文]可能会增加跌倒风险。本研究旨在比较有和没有膝关节骨关节炎的人在上下楼梯过程中[公式：见原文]的范围。七名有症状的膝关节骨关节炎患者和八名无症状对照者被要求以固定节奏上下装有仪器的楼梯。收集运动学和动力学数据，并计算矢状面、额状面和横断面的[公式：见原文]范围。膝关节骨关节炎组在上下楼梯时矢状面的[公式：见原文]均大于对照组（上楼梯时P = 0.005，科恩d = 1.7；下楼梯时P = 0.020，科恩d = 1.3），在楼梯下行时横断面的[公式：见原文]也大于对照组（P = 0.015，科恩d = 1.3）。这些观察结果可能是由于膝关节骨关节炎患者在上下楼梯时髋关节屈曲增加（P < 0.05，科恩d > 1.12）、膝关节屈曲力矩减小（P < 0.001，科恩d < -2.77）以及在楼梯下行时足部前进角度减小（P = 0.038，科恩d = -1.2）。两组在额状面[公式：见原文]上未发现显著差异（P > 0.05）。与无症状对照组相比，膝关节骨关节炎患者在上下楼梯过程中表现出更大的全身角动量。我们的研究结果可能为膝关节骨关节炎患者跌倒风险更高提供了机制上的解释。
