Reductions in peak knee abduction moment in three previously studied gait modification strategies
Reductions in peak knee abduction moment in three previously studied gait modification strategies
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DOI：
10.1016/j.knee.2019.09.017
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发表时间：
2020-01-01
期刊：
影响因子：
1.9
通讯作者：
Cortes, Nelson
中科院分区：
文献类型：
--
作者：
Lindsey, Bryndan;Eddo, Oladipo;Cortes, Nelson
背景：第一峰值内膝外展力矩 (KAM) 与膝骨关节炎有关。包括躯干倾斜、膝关节内侧推力和内八字步态在内的步态改变已被证明可以减少 KAM。由于研究设计之间的异质性，目前尚不清楚哪种策略最有效。我们比较了这些修改在健康个体中的效果，以确定其减少 KAM、膝关节内伸力矩 (KEM) 和内侧接触力 (MCF) 的有效性。方法：20 名健康个体自愿参与本研究（26.7 +/- 4.7 岁、1.75 +/- 0.1 m、73.4 +/- 12.4 kg）。通过实时生物反馈，我们根据参与者的基线平均值和标准差 (SD)，使用个性化步态参数收集了每次修改的 10 项试验。测试了每种修改的两种尺寸：前五项试验比基线大 1-3 个 SD（内八字和躯干倾斜）或小（膝盖内收），后五项试验比基线大或小 3-5 个 SD。 结果：发现 KAM 和 KEM 具有显着的主效应 (p < .001)。所有修改将 KAM 与基线相比至少降低了 5%；然而，只有膝关节内侧推力和躯干小倾斜会导致 KAM 显着降低。仅内侧膝关节推力使 KEM 较基线降低。 MCF 没有变化。结论：在减少 KAM 方面，膝关节内侧推力优于躯干倾斜和前束修正。随后 KEM 的增加和个体对修改的反应的变化表明，未来的干预措施应根据类型和幅度进行个体化，以优化 KAM 的减少并避免有害影响。 (C) 2019 Elsevier B.V. 保留所有权利。
Background: First peak internal knee abduction moment (KAM) has been associated with knee osteoarthritis. Gait modification including trunk lean, medial knee thrust, and toe-in gait have shown to reduce KAM. Due to heterogeneity between study designs, it remains unclear which strategy is most effective. We compared the effects of these modifications in healthy individuals to determine their effectiveness to reduce KAM, internal knee extension moment (KEM), and medial contact force (MCF).Methods: Twenty healthy individuals volunteered for this study (26.7 +/- 4.7 years, 1.75 +/- 0.1 m, 73.4 +/- 12.4 kg). Using real-time biofeedback, we collected 10 trials for each modification using individualized gait parameters based on participants' baseline mean and standard deviation (SD). Two sizes of each modification were tested: 1-3 SD greater (toe-in and trunk lean) or lesser (knee adduction) than baseline for the first five trials and 3-5 SD greater or lesser than baseline for the last five trials.Results: A significant main effect was found for KAM and KEM (p < .001). All modifications reduced KAM from baseline by at least five percent; however, only medial knee thrust and small trunk lean resulted in significant KAM reductions. Only medial knee thrust reduced KEM from baseline. MCF was unchanged. Conclusion: Medial knee thrust was superior to trunk lean and toe-in modifications in reducing KAM. Subsequent increases in KEM and variation in individual responses to modification suggests that future interventions should be individualized by type and magnitude to optimize KAM reductions and avoid detrimental effects. (C) 2019 Elsevier B.V. All rights reserved.