Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis
Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis
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DOI：
10.1002/art.21139
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
DeVita, P
中科院分区：
文献类型：
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作者：
Messier, SP;Gutekunst, DJ;DeVita, P
客观的。经过为期 18 个月的饮食和运动临床试验，旨在确定患有膝骨关节炎 (OA) 的超重和肥胖老年人行走时体重变化与膝关节力矩和力之间的关系。方法。数据来自 142 名久坐、超重和肥胖的老年人，这些老年人自我报告有残疾，并接受了 3 维步态分析，并有膝关节 OA 的影像学证据。步态动力学结果变量包括峰值膝关节力和峰值内部膝关节力矩。创建混合回归模型来预测后续动力学值，使用后续体重作为主要解释变量。基线体重用作协变量，因此后续体重是体重变化（即体重减轻）的替代指标。结果。随访体重与压缩力（P = 0.001）、合力（P = 0.002）、外展力矩（P = 0.03）和内旋力矩（P = 0.02）的随访峰值值之间存在显着的直接关联。体重减轻 9.8N (1 kg) 与压缩力和合力分别减少 40.6N 和 38.7N 相关。因此，每个减重单位与膝关节力减少 4 个单位类似。此外，体重减轻 9.8N (1 kg) 与膝关节外展力矩减少 1.4% (0.496 Nm) 相关。结论。我们的结果表明，体重每减轻一磅，日常活动中每一步施加在膝盖上的负荷就会减少 4 倍。每天累计数千步，这种幅度的减少似乎具有临床意义。
Objective. To determine the relationship between change in body mass and knee-joint moments and forces during walking in overweight and obese older adults with knee osteoarthritis (OA) following an 18-month clinical trial of diet and exercise.Methods. Data were obtained from 142 sedentary, overweight, and obese older adults with self-reported disability and radiographic evidence of knee OA who underwent 3-dimensional gait analysis. Gait kinetic outcome variables included peak knee-joint forces and peak internal knee-joint moments. Mixed regression models were created to predict followup kinetic values, using followup body mass as the primary explanatory variable. Baseline body mass was used as a covariate, and thus followup body mass was a surrogate measure for change in body mass (i.e., weight loss).Results. There was a significant direct association between followup body mass and peak followup values of compressive force (P = 0.001), resultant force (P = 0.002), abduction moment (P = 0.03), and medial rotation moment (P = 0.02). A weight reduction of 9.8N (1 kg) was associated with reductions of 40.6N and 38.7N in compressive and resultant forces, respectively, Thus, each weight-loss unit was associated with an similar to 4-unit reduction in knee-joint forces. In addition, a reduction in body weight of 9.8N (1 kg) was associated with a 1.4% reduction (0.496 Nm) in knee abduction moment.Conclusion. Our results indicate that each pound of weight lost will result in a 4-fold reduction in the load exerted on the knee per step during daily activities. Accumulated over thousands of steps per day, a reduction of this magnitude would appear to be clinically meaningful.