Body weight support through a walking cane in inexperienced users with knee osteoarthritis
Body weight support through a walking cane in inexperienced users with knee osteoarthritis
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DOI：
10.1016/j.gaitpost.2018.09.021
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发表时间：
2019-01-01
期刊：
影响因子：
2.4
通讯作者：
Bennell, Kim L.
中科院分区：
文献类型：
--
作者：
Hart, Julia;Hall, Michelle;Bennell, Kim L.
背景：拐杖行走是临床实践指南推荐给膝骨关节炎 (OA) 患者的一种自我管理策略。确保通过手杖获得足够的体重支撑 (%BWS) 非常重要，因为这可以减少膝关节负荷的测量。研究问题：1) 膝骨关节炎患者通过手杖获得多少体重支撑？ 2) 经过简短的简单训练后，体重支撑的测量是否会增加？方法：招募了 17 名患有膝盖疼痛但以前没有使用过拐杖的人。然后按照有限的制造商说明使用标准握把铝手杖 1 周。随后，使用仪器测力手杖对参与者进行评估，以评估通过手杖的体重支撑（％总体重）。在两次 430 米步行过程中记录力数据；在物理治疗师进行的手杖训练前 10 分钟进行一次，训练后立即进行一次。提取 BWS 的测量值（峰值力、平均力、等于平均手杖力乘以持续时间的脉冲以及手杖与地面接触的持续时间）。使用浴室秤，训练的目的是通过手杖支撑至少 10% 的体重。结果：训练前，平均峰值 BWS 为总体重的 7.2 +/- 2.5%。训练 10 分钟后，平均峰值 BWS 显着增加 28%，平均 BWS 显着增加 25%，BWS 脉冲显着增加 54% (p < 0.05)。然而，个体 BWS 对训练的反应各不相同。训练后，放置手杖的持续时间增加了 22% (p = 0.02)。通过手杖达到峰值 BWS 的时间发生在训练前接触阶段的 51% 和训练后的 53% (p = 0.05)。 意义：短期训练可以增加通过步行手杖转移体重。然而，可能需要更复杂的反馈才能实现 BWS 的目标水平。
Background: Walking canes are a self-management strategy recommended for people with knee osteoarthritis (OA) by clinical practice guidelines. Ensuring that an adequate amount of body-weight support (%BWS) is taken through the walking cane is important as this reduces measures of knee joint loading.Research question: 1) How much body weight support do people with knee OA place through a cane? 2) Do measures of body weight support increase following a brief simple training session?Methods: Seventeen individuals with knee pain who had not used a walking cane before were recruited. A standard-grip aluminum cane was then used for 1 week with limited manufacturer instructions. Following this, participants were evaluated using an instrumented force-measuring cane to assess body weight support (% total body weight) through the cane. Force data were recorded during a 430-metre walk undertaken twice; once before 10 min of cane training administered by a physiotherapist, and once immediately after training. Measures of BWS (peak force, average force, impulse equal to the average cane force times duration, and cane-ground contact duration) were extracted. Using bathroom scales, training aimed to take at least 10% body weight support through the cane.Results: Before training, the average peak BWS was 7.2 +/- 2.5% of total body weight. Following 10 min of training, there was a significant increase in average peak BWS by 28%, average BWS by 25%, and BWS impulse by 54% (p < 0.05). However, individual BWS responses to training were variable. Duration of cane placement increased by 22% after training (p = 0.02). Timing of peak BWS through the cane occurred at 51% of contact phase before training, and at 53% after training (p = 0.05).Significance: A short training session can increase the transfer of body weight through a walking cane. However, more sophisticated feedback may be needed to achieve target levels of BWS.