Factors associated with restricted hip extension during gait in women after total hip arthroplasty
Factors associated with restricted hip extension during gait in women after total hip arthroplasty
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DOI：
10.5301/hipint.5000286
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发表时间：
2015-11-01
影响因子：
1.5
通讯作者：
Ichihashi, Noriaki
中科院分区：
文献类型：
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作者：
Tsukagoshi, Rui;Tateuchi, Hiroshige;Ichihashi, Noriaki
目的：髋关节置换术患者站立后期髋伸角峰值降低是主要的步态异常。本研究的目的是确定步态时髋关节伸角峰值与肌肉无力、关节活动范围受限等功能障碍的关系，并确定影响步态时髋关节伸角峰值的临床因素。方法：对67例女性THA患者进行检查。进行生物力学步态分析，测量步态中髋部最大伸角。评估髋关节和膝关节的最大等距力量、被动髋关节伸展运动范围、腿长差异和髋关节疼痛。结果：步态时髋关节伸角峰值与被动髋伸活动度（r = 0.259）、髋关节疼痛（r = -0.264）、髋关节肌肉等长强度（r = 0.278-0.491）、膝关节伸肌（r = 0.386）显著相关。逐步多元回归分析显示，髋关节外展扭矩（β = 0.355, P = 0.001）、髋关节疼痛（β = -0.353, P = 0.001）和被动髋关节伸展活动度（β = 0.258, P = 0.011）是步态中髋关节伸展角峰值的显著影响因素（R-2 = 0.408）。结论：我们的研究结果提示，以改善步态能力为目的的THA康复应侧重于加强髋关节外展肌，控制髋关节疼痛和增加髋关节伸展活动范围。
Purpose: A decreased peak hip extension angle in the late stance phase is a major gait abnormality in patients with THA. The purpose of this study was to determine the relationship between peak hip extension angle during gait and functional impairments such as muscle weakness and the limitation in joint range of motion and to identify the clinical factors influencing peak hip extension angle during gait.Methods: 67 female volunteers with THA were examined. Biomechanical gait analysis was performed to measure peak hip extension angle during gait. Maximal isometric strength of the hip and knee, passive hip extension range of motion, leg length discrepancy, and hip pain were assessed.Results: Peak hip extension angle during gait significantly correlated with passive hip extension range of motion (r = 0.259), hip pain (r = -0.264), isometric strengths of the hip musculature (r = 0.278-0.491), and knee extensor (r = 0.386). Stepwise multiple regression analysis revealed that hip abductor torque (beta = 0.355, P = 0.001), hip pain (beta = -0.353, P = 0.001), and passive hip extension range of motion (beta = 0.258, P = 0.011) were significant contributors to peak hip extension angle during gait (R-2 = 0.408).Conclusions: Our findings suggest that THA rehabilitation aimed at improving gait ability should focus on strengthening the hip abductors, controlling hip pain and increasing range of motion of hip extension.