Lower limb alignment and foot angle are related to stance phase knee adduction in normal subjects: A critical analysis of the reliability of gait analysis data
Lower limb alignment and foot angle are related to stance phase knee adduction in normal subjects: A critical analysis of the reliability of gait analysis data
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DOI：
10.1002/jor.1100140218
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发表时间：
1996-03-01
影响因子：
2.8
通讯作者：
Andriacchi, TP
中科院分区：
文献类型：
--
作者：
Andrews, M;Noyes, FR;Andriacchi, TP
在退行性关节疾病中，影响膝关节负荷的解剖和力学因素可导致膝关节的病理改变，在治疗计划中应予以考虑。本研究的目的是量化下肢骨骼的排列、足部前进角和膝关节内收力矩之间的关系，并确定我们步态测量的可靠性。对11名健康受试者进行步态分析和下肢完整的影像学评估。步态测量用光电数字化仪和多分量测力仪记录。有影像学测量表明下肢内翻对准的受试者在站立早期膝关节内收力矩的峰值在统计学上更高。相反，下肢外翻对齐者在站立早期膝关节内收力矩的峰值较低。趾外倾角大、踝关节内翻力矩峰值低的受试者，其膝关节内收力矩峰值明显较低。这些显著的（低到中等）相关性表明，外翻程度较高的肢体和脚趾外翻步态的肢体在膝关节处表现出较低的内收峰值。为了验证数据的可重复性，对每个受试者分别在2天对每个下肢进行步态分析测试。方差分析显示，各被试的测试肢体和测试天数之间无显著差异。我们的研究结果表明，在临床环境中可以很容易测量的下肢对齐和足部进展角可以作为健康个体膝关节负荷的预测因子。这些发现可能对膝关节异常的手术和非手术治疗具有重要意义。
Anatomic and mechanical factors that affect loading in the knee joint can contribute to pathologic changes seen at the knee in degenerative joint disease and should be considered in treatment planning. The objectives of this study were to quantify the relationships between the alignment of the bones of the lower extremity, foot progression angle, and knee adduction moment, and to determine the reliability of our gait measurements. Gait analysis and complete radiographic evaluation of the lower extremity were performed on 11 healthy subjects. The gait measurements were recorded with an optoelectronic digitizer and a multi-component force plate. The subjects who had radiographic measurements indicative of varus alignment of the lower extremity had statistically higher peaks in knee adduction moment in early stance. Conversely, those with valgus alignment of the lower extremity had statistically lower peaks in knee adduction moment in early stance. The subjects who had a large toe-out angle and low ankle inversion moment peaks in late stance had significantly lower peaks in knee adduction moment in late stance. These significant (low to moderate) correlations suggest that the limbs with more valgus alignment and those with a toe-out gait exhibited a reduced peak adduction moment at the knee. To verify the reproducibility of the data, gait analysis testing was performed on each lower limb on 2 separate days for each subject. Analysis of variance showed that there was no significant difference between test limbs or test days for each subject. Our results suggest that the alignment of the lower limb and the foot progression angle, which can be readily measured in a clinical setting, can serve as predictors of knee joint loading in healthy individuals. These findings may have important implications for both surgical and nonsurgical treatment of abnormalities of the knee joint.