Roberts Oliver, Wu Tsung-Lin, Teng Phillis, Lau Jun Liang, Pua Yong Hao, Clark Ross A, Hu Yi, Tan Bryan Yijia
Rehabilitation Research Institute of Singapore, Nanyang Technological University, 11 Mandalay Rd, #14-03 Clinical Sciences Building, 308232, Singapore.
Rehabilitation Research Institute of Singapore, Nanyang Technological University, 11 Mandalay Rd, #14-03 Clinical Sciences Building, 308232, Singapore.
Clin Biomech (Bristol). 2025 Feb;122:106436. doi: 10.1016/j.clinbiomech.2025.106436. Epub 2025 Jan 17.
Stair climbing tests are pivotal when assessing physical performance in knee osteoarthritis patients, yet the biomechanical strategies that underpin poor stair climbing ability are heterogeneously reported. Single step tasks emulate a step-by-step gait pattern, an approach associated with knee pain when stair climbing. The objective of this study is to analyse the biomechanics and electromyography activity of both the leading and trailing limbs during single Step-up and Down tasks in knee osteoarthritis patients.
Three-dimensional motion analysis captured biomechanical data of twenty participants with knee osteoarthritis (n = 20) and twenty four (n = 24) age matched controls completing isolated Step-Up and Step-Down tasks. Data was collected from both the leading and trailing limbs and analysed continuously using One-dimensional Statistical Parametric Mapping (α = 0.05).
During Step-Up, knee osteoarthritis participants demonstrated kinematic (p < 0.001), kinetic (p = 0.045), and electromyography (p < 0.001) variance compared to control participants, whilst Step-Down induced elevated external knee adduction moments (p = 0.042). Across both tasks, knee osteoarthritis participants stood with increased lower limb flexion in quiet standing and spent a proportionally elevated time in transitional double stance during Step-Up (p = 0.02).
Our study reveals that knee osteoarthritis patients display distinctive biomechanical strategies during single Step-Up and Down tasks, that deviate depending on whether the osteoarthritic knee is leading or trailing. Single-step tasks are a safer and practical alternative to other stair climbing tests. We hope that clinicians can use these findings to guide treatments that promote less effortful step and stair ambulation in knee osteoarthritis patients with advanced disease.
爬楼梯测试在评估膝骨关节炎患者的身体机能时至关重要，但关于支撑爬楼梯能力差的生物力学策略的报道却各不相同。单步任务模拟一步一步的步态模式，这种方法与爬楼梯时的膝盖疼痛有关。本研究的目的是分析膝骨关节炎患者在单步上台阶和下台阶任务中，主导腿和跟随腿的生物力学和肌电图活动。
三维运动分析获取了20名膝骨关节炎患者（n = 20）和24名年龄匹配的对照组参与者（n = 24）完成单独的上台阶和下台阶任务时的生物力学数据。从主导腿和跟随腿收集数据，并使用一维统计参数映射进行连续分析（α = 0.05）。
在上台阶过程中，与对照组参与者相比，膝骨关节炎参与者表现出运动学（p < 0.001）、动力学（p = 0.045）和肌电图（p < 0.001）差异，而下台阶时导致外侧膝关节内收力矩升高（p = 0.042）。在两项任务中，膝骨关节炎参与者在安静站立时下肢屈曲增加，并且在上台阶过程中在过渡性双支撑阶段花费的时间成比例增加（p = 0.02）。
我们的研究表明，膝骨关节炎患者在单步上台阶和下台阶任务中表现出独特的生物力学策略，这取决于患骨关节炎的膝盖是主导还是跟随而有所不同。单步任务是比其他爬楼梯测试更安全、更实用的替代方法。我们希望临床医生能够利用这些发现来指导治疗，促进晚期疾病的膝骨关节炎患者更轻松地行走和爬楼梯。
