Toe-in gait reduces the first peak knee adduction moment in patients with medial compartment knee osteoarthritis
Toe-in gait reduces the first peak knee adduction moment in patients with medial compartment knee osteoarthritis
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DOI：
10.1016/j.jbiomech.2012.10.019
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发表时间：
2013-01-04
影响因子：
2.4
通讯作者：
Delp, Scott L.
中科院分区：
文献类型：
--
作者：
Shull, Pete B.;Shultz, Rebecca;Delp, Scott L.
膝关节内收的第一个高峰与内侧间隙膝关节骨性关节炎的存在、严重程度和进展有关。这项研究的目的是评估脚趾向内步态(通过脚内旋转从基线开始减少足部前进角度)作为一种方法来减少内侧间隔性膝骨性关节炎患者的膝关节内收力矩的第一峰值。此外，我们还检查了膝关节内收力矩的第一个峰值是否会导致膝关节外屈力矩的峰值随之增加，这可以消除由于降低膝关节内收力矩而导致的内侧筋膜间隔力的减少。我们检验了以下假设：(A)脚趾向内步态减少了膝关节内收力矩的第一个峰值，(B)脚趾向内步态不会增加膝关节外屈力矩的峰值。12名膝关节内侧间隙骨关节炎患者首先在运动捕捉实验室的仪表式跑步机上进行基线步行试验，然后以自己选择的速度进行脚趾内步态试验。受试者将他们的脚步前进角度从基线改变为脚尖步态平均5度(p<；0.01)，这使得膝关节内收力矩的第一个峰值平均减少了13%(p<；0.01)。趾内步态不增加膝关节最大外屈力矩(p=0.85)。早期站立时，膝关节内收力的降低伴随着膝关节中心的内移和压力中心的侧移。这些结果表明，趾尖向内步态可能是治疗膝关节内侧间隙骨关节炎的一种有前途的非手术治疗方法。(C)2012爱思唯尔有限公司。保留所有权利。
The first peak of the knee adduction moment has been linked to the presence, severity, and progression of medial compartment knee osteoarthritis. The objective of this study was to evaluate toe-in gait (decreased foot progression angle from baseline through internal foot rotation) as a means to reduce the first peak of the knee adduction moment in subjects with medial compartment knee osteoarthritis. Additionally, we examined whether the first peak in the knee adduction moment would cause a concomitant increase in the peak external knee flexion moment, which can eliminate reductions in the medial compartment force that result from lowering the knee adduction moment. We tested the following hypotheses: (a) toe-in gait reduces the first peak of the knee adduction moment, and (b) toe-in gait does not increase the peak external knee flexion moment. Twelve patients with medial compartment knee osteoarthritis first performed baseline walking trials and then toe-in gait trials at their self-selected speed on an instrumented treadmill in a motion capture laboratory. Subjects altered their foot progression angle from baseline to toe-in gait by an average of 5 degrees (p < 0.01), which reduced the first peak of the knee adduction moment by an average of 13% (p < 0.01). Toe-in gait did not increase the peak external knee flexion moment (p=0.85). The reduced knee adduction moment was accompanied by a medially-shifted knee joint center and a laterally-shifted center of pressure during early stance. These results suggest that toe-in gait may be a promising non-surgical treatment for patients with medial compartment knee osteoarthritis. (C) 2012 Elsevier Ltd. All rights reserved.