Between-Limb Kinematic Asymmetry During Gait in Unilateral and Bilateral Mild to Moderate Knee Osteoarthritis
Between-Limb Kinematic Asymmetry During Gait in Unilateral and Bilateral Mild to Moderate Knee Osteoarthritis
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DOI：
10.1016/j.apmr.2013.05.010
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发表时间：
2013-11-01
影响因子：
4.3
通讯作者：
Ferber, Reed
中科院分区：
文献类型：
--
作者：
Mills, Kathryn;Hettinga, Blayne A.;Ferber, Reed
目的：比较下肢运动不对称步态在个人与单侧和双侧症状性骨关节炎和controls.Design：横断面。设置：Laboratory。参与者：参与者（N=54）有症状的单侧（n=18）或双侧（n=18）膝关节骨关节炎。健康对照组的性别和年龄与骨关节炎组相匹配，身高和体重与骨关节炎组相似（n=18）。干预：当参与者以1.1 m/s的速度在跑步机上行走时进行三维运动分析。主要结果测量：站立、膝关节屈曲、膝关节内收和髋关节内收时的最大关节角度和速度，初始接触时的骨盆下垂，步幅，结果：在初始接触时，膝关节屈曲有显著的肢体效应（P= 0.01）。双侧骨关节炎组显示出最大的肢体间不对称（2.83度; 95%置信区间，0.88 -4.78;效应量[ES] = 0.67）。双侧骨关节炎组在初始接触时的髋内收和站立时的膝内收峰值方面也表现出肢体间不对称的趋势; ES较小（ES = 0.33和0.48）。下肢运动学是对称的控制和单侧膝关节骨性关节炎groups.Conclusions：肢体之间的不对称，即使在轻度至中度阶段的膝关节骨性关节炎。在此阶段，肢体间不对称似乎在双侧症状性疾病患者中更为普遍，这表明单侧疾病患者在膝关节骨关节炎过程中保持运动对称的时间更长。此外，早期治疗策略应针对步态对称性的恢复，并涉及双下肢的运动学变化。未来的研究需要确定这些策略在运动不对称性、疼痛和疾病进展方面的疗效。（C）2013年美国康复医学大会
Objective: To compare lower-limb kinematic asymmetries during gait in individuals with unilateral and bilateral symptomatic osteoarthritis and controls.Design: Cross-sectional.Setting: Laboratory.Participants: Participants (N=54) had symptomatic unilateral (n=18) or bilateral (n=18) knee osteoarthritis. Healthy controls were sex- and age-matched and similar in height and weight to osteoarthritis groups (n=18).Intervention: Three-dimensional motion analysis was conducted while participants walked on a treadmill at 1.1m/s.Main Outcome Measures: Maximum joint angles and velocities of the knee and hip during stance, knee flexion, knee adduction, and hip adduction at initial contact, pelvic drop, stride length, and average toe out.Results: There was a significant limb effect for knee flexion at initial contact (P=.01). The bilateral osteoarthritis group demonstrated the largest between-limb asymmetry (2.83 degrees; 95% confidence interval, .88-4.78; effect size [ES] = .67). The bilateral osteoarthritis group also displayed tendencies toward between-limb asymmetry in hip adduction at initial contact and peak knee adduction during stance; ESs were small (ES = .33 and .48). Lower-limb kinematics was symmetrical in the control and unilateral knee osteoarthritis groups.Conclusions: Between-limb asymmetries are present even at mild to moderate stages of knee osteoarthritis. During this stage, between-limb asymmetry appears to be more prevalent in patients with bilateral symptomatic disease, suggesting that patients with unilateral disease maintain kinematic symmetry for longer in the knee osteoarthritis process. Further, early treatment strategies should target the restoration of gait symmetry and involve kinematics changes in both lower limbs. Future research is needed to determine the efficacy of such strategies with respect to kinematic asymmetry, pain, and disease progression. (C)2013 by the American Congress of Rehabilitation Medicine