Changes in knee moments with contralateral versus ipsilateral cane usage in females with knee osteoarthritis
Changes in knee moments with contralateral versus ipsilateral cane usage in females with knee osteoarthritis
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DOI：
10.1016/j.clinbiomech.2004.12.005
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发表时间：
2005-05-01
影响因子：
1.8
通讯作者：
Tsang, WWN
中科院分区：
文献类型：
--
作者：
Chan, GNY;Smith, AW;Tsang, WWN
背景骨关节炎的保守治疗通常涉及教育患者减少通过患病关节传递的负荷的方法。手杖的使用就是这样一种方法，手杖相对于异常膝关节的正确放置是至关重要的。本研究的目的是比较对侧与同侧手杖使用对膝关节骨关节炎膝关节力矩的影响。14名受试者自愿参加本研究。受试者走过的力量平台，而地面反作用力和三维运动学数据被捕获使用Vicon 370系统。受试者进行行走测试：（a）无辅助，（B）使用同侧手杖，（c）使用对侧手杖。采用逆动力学计算时空、运动学和动力学变量。因变量包括髋关节和膝关节的额状面和矢状面力矩，步行速度，步频和步长。重复测量ANOVA评估步行条件之间的差异。受试者在无辅助步态条件下行走明显更快，因为节奏更高。同侧手杖使用导致步态期间髋关节（与对侧P = 0.018;与无辅助P = 0.036）和膝关节（与对侧P = 0.043;与无辅助P = 0.030）额状面峰值力矩显著更大。外侧手杖放置与最小峰值膝外展肌（P = < 0.001）和屈肌（P = < 0.001）力矩相关。膝关节畸形（内翻或外翻）对任何变量均无任何显著影响，可能是由于样本量较小。结果表明，髋关节对侧手杖放置对膝关节骨关节炎患者最有效。事实上，不使用手杖可能优于同侧使用手杖，因为后者导致最高的膝关节力矩，这种情况可能会加剧疼痛和畸形。(c)2005爱思唯尔有限公司保留所有权利。
Background. Conservative treatment for osteoarthritis often involves educating the patient in methods of decreasing the load transmitted through the diseased joint. The use of a cane is one such method and the correct placement of the cane with respect to an abnormal knee joint is crucial. The purpose of this study was to compare effects on knee moments of force of contralateral versus ipsilateral cane usage in female subjects with osteoarthritic knees.Methods. A convenience sample of 14 subjects volunteered for this study. Subjects walked over force platforms while ground reaction force and three-dimensional kinematic data were captured using a Vicon 370 System. The subjects were tested walking: (a) unaided, (b) with ipsilateral cane, and (c) with contralateral cane. Inverse dynamics were employed to calculate temporal-spatial, kinematic and kinetic variables. Dependent variables included hip and knee frontal plane and sagittal plane moments of force, walking speed, cadence and stride length. Repeated measures ANOVA assessed differences among walking conditions.Findings. Subjects walked significantly faster in the unaided gait condition owing to a higher cadence. Ipsilateral cane use resulted in significantly larger hip (versus contralateral P = 0.018; versus unaided P = 0.036) and knee (versus contralateral P = 0.043; versus unaided P = 0.030) frontal plane peak moments during gait. Contralateral cane placement was associated with the smallest peak knee abductor (P = < 0.001) and flexor (P = < 0.001) moments. Knee deformity (varus or valgus) did not have any significant effect on any variable possibly due to small sample size.Interpretation. The results suggest that as is the case for the hip contralateral cane placement is the most efficacious for persons with knee osteoarthritis. In fact, no cane use may be preferable to ipsilateral cane usage as the latter resulted in the highest knee moments of force, a situation which may exacerbate pain and deformity. (c) 2005 Elsevier Ltd. All rights reserved.