髋关节骨关节炎患者的阶段特异性步态偏差。

Stage-specific gait deviations in individuals with hip osteoarthritis.

作者信息

Subasinghe Arachchige Ransi S S, Constantinou Maria, Yeung Yi Man, He Xin, Ong Michael T Y, Yung Patrick S H, Cheung Roy T H

机构信息

Human Movement Laboratory, School of Health Sciences, Western Sydney University, New South Wales, Australia.

Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, QLD, Australia.

出版信息

Gait Posture. 2025 Jul;120:226-233. doi: 10.1016/j.gaitpost.2025.04.025. Epub 2025 Apr 24.

DOI:10.1016/j.gaitpost.2025.04.025

PMID:40288032

Abstract

OBJECTIVE

This cross-sectional study examined stage-specific biomechanical differences in individuals with hip osteoarthritis (OA) compared to healthy controls, aiming to identify markers of disease severity and progression.

METHODS

Thirty participants were categorised into three groups: healthy controls, radiographic early-to-moderate hip OA, and radiographic moderate-to-severe hip OA. Spatiotemporal, kinematic, and kinetic parameters were extracted and a one-way ANOVA was used to detect group differences. Spearman's rho correlations evaluated associations between key biomechanical parameters and the Hip Disability and Osteoarthritis Outcome Score (HOOS).

RESULTS

Participants with moderate-to-severe hip OA exhibited significantly lower gait speed (p < 0.001, Cohen's d = 2.08), cadence (p = 0.037, Cohen's d = 1.31), step length (p < 0.001, Cohen's d = 1.90), stride length (p < 0.001, Cohen's d = 1.99), early stance hip adduction moment (HAM) (p < 0.001, Cohen's d = 3.13), hip flexion moment (p < 0.001, Cohen's d = 3.42), hip extension moment (p = 0.016, Cohen's d = 1.35), and knee flexion moment (p = 0.012, Cohen's d = 1.52), alongside increased step width (p = 0.008, Cohen's d = -1.42), compared to healthy controls. Early-to-moderate hip OA participants also demonstrated significantly lower gait speed (p = 0.008, Cohen's d = 1.89), step length (p = 0.014, Cohen's d = 1.56), stride length (p = 0.008, Cohen's d = 1.72), early stance HAM (p = 0.044, Cohen's d = 1.09), and hip flexion moment (p < 0.001., Cohen's d = 2.93) relative to controls. Early stance HAM further distinguished between early and advanced stages of the disease (p = 0.016, Cohen's d = 1.25) and was positively correlated with HOOS (r = 0.604, p < 0.001).

CONCLUSION

Distinct HAM differences in early stance of gait differentiate hip OA stages. Monitoring this potential biomechanical marker may enable early detection and targeted interventions to optimise gait mechanics and improve outcomes in individuals with hip OA.

摘要

目的

本横断面研究比较了髋骨关节炎（OA）患者与健康对照者在特定阶段的生物力学差异，旨在确定疾病严重程度和进展的标志物。

方法

30名参与者被分为三组：健康对照者、X线检查显示早期至中度髋OA患者、X线检查显示中度至重度髋OA患者。提取时空、运动学和动力学参数，并使用单因素方差分析来检测组间差异。Spearman等级相关分析评估关键生物力学参数与髋关节残疾和骨关节炎结果评分（HOOS）之间的关联。

结果

与健康对照者相比，中度至重度髋OA患者的步态速度（p<0.001，Cohen's d = 2.08）、步频（p = 0.037，Cohen's d = 1.31）、步长（p<0.001，Cohen's d = 1.90）、步幅（p<0.001，Cohen's d = 1.99）、早期站立期髋关节内收力矩（HAM）（p<0.001，Cohen's d = 3.13）、髋关节屈曲力矩（p<0.001，Cohen's d = 3.42）、髋关节伸展力矩（p = 0.016，Cohen's d = 1.35）和膝关节屈曲力矩（p = 0.012，Cohen's d = 1.52）显著降低，同时步宽增加（p = 0.008，Cohen's d = -1.42）。与对照者相比，早期至中度髋OA患者的步态速度（p = 0.008，Cohen's d = 1.89）、步长（p = 0.014，Cohen's d = 1.56）、步幅（p = 0.008，Cohen's d = 1.72）、早期站立期HAM（p = 0.044，Cohen's d = 1.09）和髋关节屈曲力矩（p<0.001，Cohen's d = 2.93）也显著降低。早期站立期HAM进一步区分了疾病的早期和晚期阶段（p = 0.016，Cohen's d = 1.25），并且与HOOS呈正相关（r = 0.604，p<0.001）。