Duan Bixuan, Zhang Yuxuan, Ma Pei, Chen Fangmin, Li Wei
School of Special Education and Rehabilitation, Binzhou Medical University, Binzhou, 256600, China.
Department of Rehabilitation, Binzhou Medical University Hospital, Binzhou, 256600, China.
BMC Musculoskelet Disord. 2025 Jul 9;26(1):673. doi: 10.1186/s12891-025-08920-5.
Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients.
Cross-sectional data from 30 elderly patients with KOA (age 40-65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system.
In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SI of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SI of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SI of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01).
High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. FOM can significantly affect patients' kinematic and kinetic parameters, especially PHIM and PKAM.Therefore, psychology-related interventions for treating KOA must be valued to improve patients' overall sports function and quality of life.
The study was retrospectively registered on Chinese Trial Registry (PID: 246580).
膝关节骨关节炎（KOA）在老年人群中患病率很高，给家庭和社会带来了沉重负担。本研究旨在探讨KOA患者运动恐惧（FOM）与步态特征之间的关系。
采用30例年龄在40-65岁之间的老年KOA患者的横断面数据。根据坦帕运动恐惧量表（TSK-17）中的鉴别性问题（Q9），将他们分为高恐惧组（n = 15）和低恐惧组（n = 15）。另外，选取15名健康受试者作为对照组。所有参与者被要求跨过一个高度为腿长20%的障碍物。使用三维运动捕捉系统评估包括髋、膝和踝关节角度以及双下肢力矩在内的步态参数。
组内比较显示，高恐惧组在摆动期患侧与健侧之间的膝关节屈曲角度（KFA，P = 0.04，ES = 0.70）、踝关节内收/外展力矩峰值（PAAM，P = 0.001，ES = 0.90）和膝关节内收/外展力矩峰值（PKAM，P = 0.006，ES = 0.97）存在差异。在站立期，患侧与健侧之间的髋关节内/外旋力矩峰值（PHIM，P = 0.005，ES = 0.87）和PKAM（P < 0.001，ES = 0.91）存在差异。组间比较显示，摆动期高恐惧组与低恐惧组之间的髋关节内收角（HAA）不对称指数（SI）存在差异（P = 0.003）。在站立期，对照组的PAAM（P = 0.004）、PHIM（P = 0.002）的SI大于高恐惧组。相关性分析显示，TSK-17评分与PKAM（r = 0.80，P < 0.01）和PHIM（r = 0.81，P < 0.01）的SI密切相关。
高恐惧的KOA患者可能会采取保护性运动策略，这可能会通过减少患侧负重导致运动模式不对称。FOM会显著影响患者的运动学和动力学参数，尤其是PHIM和PKAM。因此，必须重视针对KOA的心理相关干预措施，以提高患者的整体运动功能和生活质量。
本研究在中国临床试验注册中心进行回顾性注册（注册号：246580）。
