Effects of loss of metatarsophalangeal joint mobility on gait in rheumatoid arthritis patients
Effects of loss of metatarsophalangeal joint mobility on gait in rheumatoid arthritis patients
复制标题
DOI：
10.1093/rheumatology/kei168
复制
发表时间：
2006-04-01
期刊：
影响因子：
5.5
通讯作者：
Maillefert, JF
中科院分区：
文献类型：
--
作者：
Laroche, D;Pozzo, T;Maillefert, JF
客观的。评估跖趾 (MTP) 关节活动度 (ROM) 丧失对类风湿性关节炎 (RA) 患者行走运动学参数的影响。方法。纳入疾病不活动、无下肢滑膜炎且 MTP 关节活动度降低的 RA 患者。使用三维计算机化运动分析评估 MTP 背屈和跖屈的 ROM 以及步态分析。计算步行时的步态参数以及髋部和膝部的最大屈曲和伸展。分析1 比较有或没有行走疼痛患者的背屈和跖屈的ROM； 2 比较患者和对照组的步态参数； 3 研究了步态参数与 (i) MTP 背屈和跖屈的 ROM 以及 (ii) 行走时的疼痛之间的关系； 4.研究了步行时MTP背屈和跖屈的ROM与髋关节和膝关节的最大屈曲和伸展之间的关系。结果。包括九名患者和七名对照者。无论有或没有行走疼痛的患者，MTP ROM 没有差异。与对照组相比，患者的行走速度较低，步幅较短。步行速度和步幅与MTP背屈ROM呈正相关(r(2)=0.75和0.67)。步行过程中膝关节和髋关节的最大屈曲与潜在的MTP背屈ROM之间存在负相关关系（r(2)=0.67和0.54）。结论。在 RA 患者中，MTP 背屈活动度降低会导致步行参数发生变化，包括下肢关节的运动学。 RA 前足损伤的治疗应重点关注 MTP 的灵活性和疼痛。
Objective. To evaluate the effects of loss of range of motion (ROM) of the metatarsophalangeal (MTP) joint on the kinematic parameters of walking in rheumatoid arthritis (RA) patients.Methods. Inclusion of RA patients with inactive disease, no synovitis of the inferior limb and reduced ROM of the MTP joints. Evaluation of the ROM of the MTP dorsal and plantar flexion, and gait analysis using a three-dimensional computerized movement analysis. Calculation of gait parameters and maximal flexion and extension of the hips and knees during walking. Analysis 1 compared the ROM of dorsal and plantar flexion in patients with or without walking pain; 2 compared the gait parameters between patients and controls; 3 investigated a relationship between gait parameters and (i) the ROM of the MTP dorsal and plantar flexion and (ii) the pain at walking; 4 investigated the relationship between the ROM of the MTP dorsal and plantar flexion and maximal flexion and extension of the hip and knee joints during walking.Results. Nine patients and seven controls were included. The MTP ROM was no different in patients presenting with or without pain at walking. The walking velocity was lower and the stride length shorter in patients than in controls. The walking velocity and the stride length were positively related to the MTP dorsal flexion ROM (r(2)=0.75 and 0.67). There was a negative relationship between maximal flexion of the knee and hips during walking and the underlying MTP dorsal flexion ROM (r(2)=0.67 and 0.54).Conclusion. In RA patients, reduced MTP dorsal flexion mobility induces changes in the walking parameters, including the kinematics of the overlying lower limb joints. Treatment of an RA-impaired forefoot should focus on MTP mobility as well as on pain.