Kinematic approach to gait analysis in patients with rheumatoid arthritis involving the knee joint.
Kinematic approach to gait analysis in patients with rheumatoid arthritis involving the knee joint.
复制标题
涉及膝关节的类风湿关节炎患者步态分析的运动学方法。
作者：
M. Sakauchi;K. Narushima;H. Sone;Y. Kamimaki;Y. Yamazaki;S. Kato;T. Takita;N. Suzuki;K. Moro
目的
分析类风湿关节炎膝关节病变患者的异常步态模式。
方法
在2组类风湿性关节炎患者中，通过电磁跟踪仪分析矢状面相关角度参数的变化。一组包括膝关节受累和严重炎症但无进行性破坏的患者;另一组膝关节受累伴进行性破坏和低疾病活动度。膝关节角度测量为3个传感器（髋-膝-踝）形成的矢状面中的投影角度;显示变化的平均角度、角速度和角加速度。此外，连续测量每个传感器位移的矢量元素端点所形成的角度（指定为α角）。
结果
与年龄匹配的对照组相比，膝关节严重炎症受累患者在站立期α角变化有限，膝关节破坏患者摆动期持续时间缩短，摆动期α角变化减少。在后者中观察到尖锐的α角速度变化曲线。炎症和破坏组之间的特征差异在α角比膝关节角本身更明显。
结论
我们观察了活动性炎性关节炎膝关节受累而无进行性破坏的类风湿性关节炎患者与关节破坏和轻微炎症患者之间的步态差异。类风湿关节炎步态障碍的特点并不简单，即使是单一的主要部位。因此，生物动力学步态分析等技术可以提供有关该患者人群功能性关节完整性的实用信息，有助于制定治疗决策。
OBJECTIVE
To analyze abnormal gait patterns in patients with rheumatoid arthritis involving the knee joint.
METHODS
In 2 patient groups with rheumatoid arthritis, changes in relevant angular parameters in the sagittal plane were analyzed by an electromagnetic tracking instrument. One group consisted of patients with knee joint involvement and severe inflammation without progressive destruction; the other group had knee joint involvement with progressive destruction and low disease activity. Knee angle was measured as the projected angle in the sagittal plane formed by 3 sensors (hip-knee-ankle); the changing mean angle, angular velocity, and angular acceleration were displayed. Furthermore, the angle formed by the vector element's endpoints for each sensor's displacement (designated alpha angle) was measured continuously.
RESULTS
Compared with age-matched controls, patients with severe inflammatory knee joint involvement showed limitation of alpha angle change in the stance phase, and patients with knee joint destruction had shortened swing phase duration and decreased alpha angle change in the swing phase. A sharpened alpha angular velocity change curve was observed in the latter. Characteristic differences between groups with inflammation and destruction were more clearly evident from the alpha angle than from the knee angle itself.
CONCLUSION
We observed gait differences between rheumatoid arthritis patients with active inflammatory arthritic knee joint involvement without progressive destruction and those with joint destruction and minimal inflammation. Features of gait disturbance in rheumatoid arthritis were not simple, even with a single major site. Therefore, techniques such as biokinetic gait analysis can provide practical information about functional joint integrity in this patient population that could aid in therapeutic decision making.