Knee joint kinematics, kinetics and muscle co-contraction in knee osteoarthritis patient gait
Knee joint kinematics, kinetics and muscle co-contraction in knee osteoarthritis patient gait
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DOI：
10.1016/j.clinbiomech.2009.08.005
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发表时间：
2009-12-01
影响因子：
1.8
通讯作者：
Ackland, Timothy R.
中科院分区：
文献类型：
--
作者：
Heiden, Tamika L.;Lloyd, David G.;Ackland, Timothy R.
背景：与对照组相比，膝关节骨关节炎患者行走时运动学、动力学和肌肉活动发生改变。骨关节炎患者步态的研究集中在个体测量上，由于患者残疾程度和年龄的差异，这些研究的结果不同。因此，本研究的目的是检查运动学，动力学和肌肉共收缩步态变量在一个单一的骨关节炎患者组，并确定这些变量的变化是否与疼痛，症状和功能measures.Methods：30无症状对照组和54例膝关节骨关节炎的影像学证据参与。自我感知的措施的疼痛和症状，步态（膝关节角度，时刻和肌肉共同收缩）进行了分析和compared.Findings：骨关节炎患者有更大的自我感知的疼痛和症状的问卷调查。膝关节骨关节炎患者的步态差异是脚跟着地时和站立早期沿着的膝关节屈曲更大，站立后期的膝关节外伸力矩峰值降低。共收缩率强调了骨关节炎患者更大的外侧肌肉激活，这与他们的内收力矩的大小相关。较大的内收力矩与较低的自我感知的疼痛和symptoms.Interpretation：骨关节炎患者主要使用侧肌激活的立场，这可能有助于稳定的外部膝关节内收力矩。膝关节骨关节炎患者步态的运动学改变在膝关节力矩没有改变的情况下发生。我们的研究结果还表明，内收力矩降低，以减少患者的疼痛和症状。(C)2009爱思唯尔有限公司保留所有权利。
Background: Compared to matched controls, knee osteoarthritis patients walk with altered, kinematics, kinetics and muscle activity. Studies of osteoarthritis patient gait have focused on individual measures, and findings from these studies differ due to differences in patient levels of disability and age. Therefore, aims of this study were to examine kinematic, kinetic and muscle co-contraction gait variables within a single osteoarthritis patient group, and to determine if alterations in these variables are related to pain, symptom and function measures.Methods: Thirty asymptomatic controls and 54 patients with radiographic evidence of knee osteoarthritis participated. Self-perceived measures of pain and symptoms, and gait (knee joint angles, moments and muscle co-contraction) were analysed and compared.Findings: Osteoarthritis patients had greater self-perceived pain and symptoms on the questionnaires. Gait differences in the knee osteoarthritis patients were greater knee flexion at heel strike and during early stance along with reductions in the peak external knee extension moment in late stance. Co-contraction ratios highlighted greater lateral muscle activation in osteoarthritis patients, which were correlated with the magnitude of their adduction moments. Larger adduction moments were related to lower self-perceived pain and symptoms.Interpretation: Osteoarthritis patients use predominantly lateral muscle activation during stance which may aid in stabilising the external knee adduction moment. Kinematic alterations in knee osteoarthritis patient gait occur without alterations in knee joint moments. Our results also suggest that adduction moments are lowered to reduce the patients' pain and symptoms. (C) 2009 Elsevier Ltd. All rights reserved.