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马凡氏综合征患者在行走过程中会出现髋关节总关节力矩的改变。

Alterations of the hip total joint moment occur during walking in individuals with Marfan syndrome.

作者信息

Sharp Amara G, Jacobs Mariana V, Mangino Anthony A, Clasey Jody L, Sheppard Mary B, Samaan Michael A

机构信息

Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, USA.

Department of Biostatistics, University of Kentucky, Lexington, KY, USA.

出版信息

Clin Biomech (Bristol). 2025 Jul;127:106570. doi: 10.1016/j.clinbiomech.2025.106570. Epub 2025 May 31.

Abstract

BACKGROUND

Marfan Syndrome is an inherited connective tissue disorder associated with musculoskeletal weakness, ligamentous laxity, and lower extremity joint pain. Approximately 46 % of individuals with Marfan Syndrome report hip-related pain yet the underlying alterations that occur in hip joint moments during gait in the Marfan population is not well understood. The purpose of this study was to assess the hip total joint moment during walking in individuals with Marfan Syndrome compared to healthy controls.

METHODS

Overground 3D gait analysis at a fixed walking speed was conducted for eighteen individuals with Marfan Syndrome and eighteen sex and BMI matched, asymptomatic controls. The total joint moment was calculated as the square root of the sum of the squared planar internal sagittal, frontal, and transverse plane hip moments across the stance phase. Between group differences in peak hip total joint moment and the planar contributions to the peak hip total joint moments during the first and second halves of stance were assessed using an analysis of covariance.

FINDINGS

Compared to the control group, the Marfan group walked with greater first peak total hip joint moments (p = 0.01), greater sagittal plane percent contribution (p = 0.03), and greater frontal plane moments (p = 0.02), and frontal plane contributions (p = 0.02) to the hip total joint moment in the first and second half of stance.

INTERPRETATION

Higher internal abduction moments at the first and second peak total joint moment may serve as a biomechanical target for gait interventions to reduce hip joint loading that may be associated with hip-related pain in the Marfan population.

摘要

背景

马凡综合征是一种遗传性结缔组织疾病,与肌肉骨骼无力、韧带松弛和下肢关节疼痛有关。约46%的马凡综合征患者报告有髋关节相关疼痛,但马凡人群在步态中髋关节力矩发生的潜在改变尚不清楚。本研究的目的是评估马凡综合征患者与健康对照者在行走过程中的髋关节总关节力矩。

方法

对18名马凡综合征患者以及18名性别和体重指数匹配的无症状对照者进行了固定步行速度下的地面三维步态分析。总关节力矩计算为整个站立相平面内矢状面、额状面和横断面髋关节力矩平方和的平方根。使用协方差分析评估两组在站立相前半段和后半段的峰值髋关节总关节力矩以及峰值髋关节总关节力矩的平面贡献之间的组间差异。

结果

与对照组相比,马凡组在站立相的前半段和后半段行走时,首次峰值髋关节总关节力矩更大(p = 0.01),矢状面百分比贡献更大(p = 0.03),额状面力矩更大(p = 0.02),以及对髋关节总关节力矩的额状面贡献更大(p = 0.02)。

解读

首次和第二次峰值总关节力矩时更高的内收力矩可能是步态干预的生物力学靶点,以减少可能与马凡人群髋关节相关疼痛有关的髋关节负荷。

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