The Effect of Gait Modification on the Response of Medial Meniscus Extrusion During Gait in Patients with Knee Osteoarthritis
The Effect of Gait Modification on the Response of Medial Meniscus Extrusion During Gait in Patients with Knee Osteoarthritis
复制标题
步态改变对膝骨关节炎患者步态中内侧半月板挤压反应的影响
DOI：
10.1016/j.gaitpost.2023.03.017
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发表时间：
2023
期刊：
影响因子：
2.4
通讯作者：
Nobuo Adachi
中科院分区：
文献类型：
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作者：
Saeko Okamoto;Yosuke Ishii;Masakazu Ishikawa;Yuko Nakashima;Goki Kamei;Yoshitaka Iwamoto;Takato Hashizume;Kaoru Okada;Kazuya Takagi;Makoto Takahashi;Nobuo Adachi
背景负重条件下内侧半月板挤压的增加与内侧膝骨关节炎（OA）的进展相关。众所周知，外八字步态修正可以减少膝关节内收力矩 (KAM)；研究问题：（1）评估外八字步态对膝关节内侧半月板挤压增加的影响以及膝关节内侧OA患者的KAM；（2）研究外侧楔形鞋垫与外八字步态相结合的协同效应，以确定减少步态期间内侧半月板挤压的最有效干预措施。方法25膝关节内侧 OA 患者纳入本研究。参与者在四种情况下行走：正常步态、外八字步态、使用外侧楔形鞋垫的正常步态以及使用外侧楔形鞋垫的脚趾向外步态。在每种情况下，使用超声波和三维运动分析系统测量步态期间的内侧半月板挤压和 KAM 峰值。使用重复测量方差分析对四种条件下的这些参数进行比较。结果与正常步态期间观察到的相比，所有干预措施中内侧半月板挤压和第二 KAM 峰值的增加均显着降低。然而，干预措施之间没有显着差异。意义这项研究表明，外八字步态减少了内侧半月板挤压的增加，并与第二个 KAM 峰值的减少相关。然而，没有观察到侧向楔形鞋垫和外八字步态的协同作用。
BackgroundAn increase in medial meniscus extrusion during weight-bearing conditions is associated with the progression of medial knee osteoarthritis (OA). Toe-out gait modification has been known to reduce the knee adduction moment (KAM); however, its effect on reducing the increase in medial meniscus extrusion in patients with knee OA remains unclear.Research questionTo (1) evaluate the effect of toe-out gait on the increase in medial meniscus extrusion and the KAM in patients with medial knee OA and (2) investigate the synergetic effect of lateral wedge insoles in combination with toe-out gait in determining the most effective intervention for reducing medial meniscus extrusion during gait.MethodsTwenty-five patients with medial knee OA were enrolled in this study. Participants walked under four conditions: normal gait, toe-out gait, normal gait with lateral wedge insoles, and toe-out gait with lateral wedge insoles. Medial meniscus extrusion and KAM peaks during gait were measured using ultrasound and a three-dimensional motion analysis system in each condition. These parameters were compared among the four conditions using repeated measures analysis of variance.ResultsThe increase in medial meniscus extrusion and the second KAM peak were significantly lower in all interventions compared with those observed during normal gait. However, there was no significant difference among the interventions.SignificanceThis study suggested that toe-out gait reduces the increase in medial meniscus extrusion and is associated with the reduction of the second KAM peak. However, no synergistic effect of lateral wedge insoles and toe-out gait was observed.