Effective gait patterns for offloading the medial compartment of the knee.
Effective gait patterns for offloading the medial compartment of the knee.
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DOI：
10.1002/jor.20843
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发表时间：
2009-08
影响因子：
2.8
通讯作者：
Colwell, Clifford W., Jr.
中科院分区：
文献类型：
--
作者：
Fregly, Benjamin J.;D'Lima, Darryl D.;Colwell, Clifford W., Jr.
步态改变为膝关节骨关节炎患者的膝关节内侧腔室减压提供了一种非侵入性的选择。虽然已经提出了基于其减少膝关节外内收力矩的能力的步态修改，但没有一种步态模式被证明可以直接减少内侧隔室接触力。本研究使用从单个受试者收集的体内接触力数据，通过测量膝关节置换术来评估两种步态模式在实现这一目标方面的有效性。第一种是“内侧推力”步态模式，在站立阶段涉及膝关节中间化，而第二种是“步行杆”步态模式，涉及使用通常用于徒步旅行的双侧步行杆。与受试者的正常步态模式相比，内侧推力步态在站立阶段产生16%的内侧接触力减少，步行杆步态产生27%的内侧接触力减少，基于双尾Mann-Whitney u检验，两者均具有统计学意义。在站立阶段，内侧推力步态对侧力和总接触力的影响很小，而步行杆步态对侧力和总接触力的影响分别为11%和21%。内侧推力步态可以使膝关节骨关节炎患者在不需要外部设备的情况下，通过看起来正常的行走运动来减少内侧接触力，而步行杆步态可以使膝关节骨关节炎或膝关节置换术患者在可能使用步行杆的情况下减少内侧、外侧和全部接触力。
Gait modification offers a non-invasive option for offloading the medial compartment of the knee in patients with knee osteoarthritis. While gait modifications have been proposed based on their ability to reduce the external knee adduction moment, no gait pattern has been proven to reduce medial compartment contact force directly. This study used in vivo contact force data collected from a single subject with a force-measuring knee replacement to evaluate the effectiveness of two gait patterns at achieving this goal. The first was a “medial thrust” gait pattern that involved medializing the knee during stance phase, while the second was a “walking pole” gait pattern that involved using bilateral walking poles commonly used for hiking. Compared to the subject's normal gait pattern, medial thrust gait produced a 16% reduction and walking pole gait a 27% reduction in medial contact force over stance phase, both of which were statistically significant based on a two-tailed Mann-Whitney U-test. While medial thrust gait produced little change in lateral and total contact force over the stance phase, walking pole gait produced significant 11% and 21% reductions, respectively. Medial thrust gait may allow patients with knee osteoarthritis to reduce medial contact force using a normal-looking walking motion requiring no external equipment, while walking pole gait may allow patients with knee osteoarthritis or a knee replacement to reduce medial, lateral, and total contact force in situations where the use of walking poles is possible.
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DOI：
10.1002/art.23326
发表时间：
2008-03-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Hinman, Rana S.;Payne, Craig;Bennell, Kim L.
通讯作者：
Bennell, Kim L.
DOI：
10.2106/00004623-198264090-00008
发表时间：
1982-01-01
影响因子：
5.3
作者：
ANDRIACCHI, TP;GALANTE, JO;FERMIER, RW
通讯作者：
FERMIER, RW
影响因子：
2.8
作者：
Zhao, Dong;Banks, Scott A.;Fregly, Benjamin J.
通讯作者：
Fregly, Benjamin J.
影响因子：
2.4
作者：
CHAO, EY;LAUGHMAN, RK;STAUFFER, RN
通讯作者：
STAUFFER, RN
影响因子：
2.4
作者：
D'Lima, DD;Townsend, CP;Colwell, CW
通讯作者：
Colwell, CW