Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait.
Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait.
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DOI：
10.1371/journal.pone.0174663
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Lewis CL
中科院分区：
文献类型：
--
作者：
Li JS;Tsai TY;Felson DT;Li G;Lewis CL
膝关节疼痛是肥胖患者的常见症状，步行通常是治疗方案的一部分。过去对肥胖个体的研究主要集中在矢状面和冠状面的站立位对齐和运动学。研究6自由度（6DOF）站立和步态中的膝关节运动学对于彻底了解患有膝关节疼痛的肥胖个体的膝关节功能非常重要。本研究旨在使用经验证的X线透视成像系统研究肥胖患者站立和步态期间的6自由度膝关节运动学。招募了10名肥胖和膝关节疼痛的个体。站立时，膝关节过伸7.4±6.3°，外展2.8±3.3°，外旋5.6±7.3°。股骨中心位于胫骨中心前方0.7±3.1mm和内侧5.1±1.5mm。在跑步机步态期间，矢状面运动，即，屈曲/伸展和前后平移，显示出清晰的模式。具体而言，与健康的非肥胖组相比，患有膝关节疼痛的肥胖个体在步态周期的大部分站立阶段期间保持膝关节更多的屈曲和更多的胫骨前平移，并且膝关节屈曲的总范围减少。总之，在6DOF分析中，膝关节疼痛的肥胖个体在站立时使用过伸膝姿势，但在步态期间保持膝关节更多屈曲，整体活动范围减少。
Knee joint pain is a common symptom in obese individuals and walking is often prescribed as part of management programs. Past studies in obese individuals have focused on standing alignment and kinematics in the sagittal and coronal planes. Investigation of 6 degree-of-freedom (6DOF) knee joint kinematics during standing and gait is important to thoroughly understand knee function in obese individuals with knee pain. This study aimed to investigate the 6DOF knee joint kinematics in standing and during gait in obese patients using a validated fluoroscopic imaging system. Ten individuals with obesity and knee pain were recruited. While standing, the knee was in 7.4±6.3°of hyperextension, 2.8±3.3° of abduction and 5.6±7.3° of external rotation. The femoral center was located 0.7±3.1mm anterior and 5.1±1.5mm medial to the tibial center. During treadmill gait, the sagittal plane motion, i.e., flexion/extension and anterior-posterior translation, showed a clear pattern. Specifically, obese individuals with knee pain maintained the knee in more flexion and more anterior tibial translation during most of the stance phase of the gait cycle and had a reduced total range of knee flexion when compared to a healthy non-obese group. In conclusion, obese individuals with knee pain used hyperextension knee posture while standing, but maintained the knee in more flexion during gait with reduced overall range of motion in the 6DOF analysis.