Effects of toe-in and toe-in with wider step width on level walking knee biomechanics in varus, valgus, and neutral knee alignments
Effects of toe-in and toe-in with wider step width on level walking knee biomechanics in varus, valgus, and neutral knee alignments
复制标题
DOI：
10.1016/j.knee.2017.08.058
复制
发表时间：
2017-12-01
期刊：
影响因子：
1.9
通讯作者：
Zhang, Songning
中科院分区：
文献类型：
--
作者：
Bennett, Hunter J.;Shen, Guangping;Zhang, Songning
背景资料：与健康和中性对线的对应者相比，膝关节骨关节炎和膝内翻对线的个体存在增加的峰值膝关节外收力矩。增加前束或增加步宽的行走已分别用于成功降低第1和第2峰膝关节内收力矩，但之前未在所有对线组中进行组合或测试。本研究的目的是比较脚趾，脚趾在更广泛的步宽步态修改个人中立，外翻，内翻alignment.Methods：38名健康参与者确认内翻，中立，或外翻额状面膝关节排列通过前后位X光片，进行水平行走正常，脚趾，脚趾在更广泛的步宽步态。3 × 3（组×干预）混合模型重复测量ANOVA比较对齐组和步态干预（p < 0.05）。结果：与正常步态相比，脚趾内收和脚趾内收的第一峰值膝关节内收力矩均降低。与正常和足趾内收相比，足趾内收的第二峰值内收力矩增加，且步长更宽。与正常步态相比，内收冲动在前束和前束具有更宽的步宽时也减少。峰值膝关节屈曲和外旋力矩增加脚趾和脚趾在更广泛的步宽相比，正常gaet.Conclusion：虽然脚趾在更广泛的步宽步态似乎是一个可行的选择，以减少峰值内收力矩内翻对齐，矢状面，和横向膝关节负荷时，应监测这种步态修改策略。(C)2017 Elsevier B.V.版权所有。
Background: Increased peak external knee adduction moments exist for individuals with knee osteoarthritis and varus knee alignments, compared to healthy and neutrally aligned counterparts. Walking with increased toe-in or increased step width have been individually utilized to successfully reduce 1st and 2nd peak knee adduction moments, respectfully, but have not previously been combined or tested among all alignment groups. The purpose of this study was to compare toe-in only and toe-in with wider step width gait modifications in individuals with neutral, valgus, and varus alignments.Methods: Thirty-eight healthy participants with confirmed varus, neutral, or valgus frontal plane knee alignment through anteroposterior radiographs, performed level walking in normal, toe-in, and toe-in with wider step width gaits. A 3 x 3 (group x intervention) mixed model repeated measures ANOVA compared alignment groups and gait interventions (p < 0.05).Results: The 1st peak knee adduction moment was reduced in both toe-in and toe-in with wider step width compared to normal gait. The 2nd peak adduction moment was increased in toe-in compared to normal and toe-in with wider step width. The adduction impulse was also reduced in toe-in and toe-in with wider step width compared to normal gait. Peak knee flexion and external rotation moments were increased in toe-in and toe-in with wider step width compared to normal gait.Conclusion: Although the toe-in with wider step width gait seems to be a viable option to reduce peak adduction moments for varus alignments, sagittal, and transverse knee loadings should be monitored when implementing this gait modification strategy. (C) 2017 Elsevier B.V. All rights reserved.