Patients with unilateral ankle arthritis have decreased discrete and time-series limb symmetry compared to healthy controls.
Patients with unilateral ankle arthritis have decreased discrete and time-series limb symmetry compared to healthy controls.
复制标题
与健康对照相比，单侧踝关节炎患者的离散和时间序列肢体对称性降低。
DOI：
10.1002/jor.25541
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Queen,Robin
中科院分区：
文献类型：
--
作者：
Stark,NicoleE-P;Streamer,Jill;Queen,Robin
踝关节炎(AA)患者在踝关节和时空测量上存在两侧肢体的差异；然而，肢体之间的对称性程度尚未与健康人群进行比较。本研究的目的是在比较单侧再障患者和健康受试者时，确定单侧再障患者和健康受试者在步行过程中肢体对称性的差异。37名AA和37名健康参与者的年龄、性别和体重指数匹配。在4到7条步行轨迹中捕捉到了三维步态力学和地面反作用力(GRF)。每一次试验都提取了GRF以及髋关节和脚踝的力学参数。使用归一化对称性指数和统计参数映射分别评估离散和时间序列的对称性。使用线性混合效应模型对离散对称性进行分析，以确定组间的显着性差异(α= 0.05)。与健康受试者相比，AA患者的体重承受性(p= 0.017)和推进性(p<； 0.001)GRF、踝关节足屈(p= 0.021)、踝关节背屈(p= 0.010)和踝关节足屈力矩(p<； 0.001)对称性降低。在整个站立阶段，在垂直GRF力(p<； 0.001)、推离过程中的踝关节角度(p= 0.047)、足屈力矩(p<； 0.001)以及髋关节伸展角度(p= 0.034)和力矩(p= 0.010)方面，四肢和组之间存在显著差异。AA患者在站立阶段的负重承受期和推进阶段，垂直GRF、踝关节和髋部对称性降低。因此，临床医生应该尝试非改善对称性，重点是在步态的重量承受和推进阶段改变髋关节和脚踝的力学。
Patients with ankle arthritis (AA) have side‐to‐side limb differences at the ankle and in spatiotemporal measures; however, the degree of symmetry between limbs has not been compared to a healthy population. The purpose of this study was to determine differences in limb symmetry during walking for discrete and time‐series measures when comparing patients with unilateral AA to healthy participants. Thirty‐seven AA and 37 healthy participants were age, gender, and body mass index matched. Three‐dimensional gait mechanics and ground reaction force (GRF) were captured during four to seven walking trails. GRF and hip and ankle mechanics were extracted bilaterally for each trial. The Normalized Symmetry Index and Statistical Parameter Mapping were used to assess discrete and time‐series symmetry, respectively. Discrete symmetry was analyzed using linear mixed‐effect models to determine significant differences between groups (α= 0.05). Compared to healthy participants, patients with AA had decreased weight acceptance (p= 0.017) and propulsive (p< 0.001) GRF, ankle plantarflexion (p= 0.021), ankle dorsiflexion (p= 0.010), and ankle plantarflexion moment (p< 0.001) symmetry. Significant regions of difference were found between limbs and groups throughout the stance phase for the vertical GRF force (p< 0.001), the ankle angle during push‐off (p= 0.047), the plantarflexion moment (p< 0.001), and the hip extension angle (p= 0.034) and moment (p= 0.010). Patients with AA have decreased symmetry in the vertical GRF and at the ankle and hip during the weight acceptance and propulsive portions of the stance phase. Therefore, clinicians should try a non improving symmetry focusing on changing hip and ankle mechanics during the weight acceptance and propulsive phases of gait.