Assessment of Knee Kinematics in Older Adults Using High-Speed Stereo Radiography.
Assessment of Knee Kinematics in Older Adults Using High-Speed Stereo Radiography.
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DOI：
10.1249/mss.0000000000001350
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发表时间：
2017-11
影响因子：
4.1
通讯作者：
Shelburne KB
中科院分区：
文献类型：
--
作者：
Kefala V;Cyr AJ;Harris MD;Hume DR;Davidson BS;Kim RH;Shelburne KB
膝关节运动的量化对于评估病理性关节功能至关重要，例如跟踪骨关节炎的进展以及评估保守或手术治疗（包括全膝关节置换术）后的结果。我们的目的是为进行日常生活活动的健康老年人膝关节运动的运动学包络线建立一个有用的基线。采用高速立体x线摄影系统测量了8例55岁以上的健康人（4女4男，年龄61.7±5.4岁，体重74.6±7.7 kg，体重指数26.7±4.4 kg·m−2，身高168.2±13.7 cm）在坐式膝关节伸展、水平行走、旋转和台阶下降时的胫股骨三维运动学。正常行走时站立时的内外旋、内翻外翻旋转和前后活动范围平均分别为3.6°±1.1°、2.3°±0.6°和3.4±1.57 mm。在内外旋转（平均6.5°±3.1°）和前后移动（平均4.5±1.1°）的降压过程中，受试者的平均活动范围更大。在旋转期间，平均内外运动范围增加到13.5°±3.6°。每个受试者在内外翻旋转时膝关节的活动范围几乎相同，很少超过6°。行走时的旋转和下步比正常步态有更大的内外旋转和前后平移。内-外旋转和前后平移显示出更大的活动依赖性，而内-外翻旋转在活动中是一致的。这些结果与先前在年轻人群中的测量结果相似，尽管在老年人中观察到活动范围减小的趋势。
Quantification of knee motion is essential for assessment of pathologic joint function, such as tracking osteoarthritis progression and evaluating outcomes after conservative or surgical treatment, including total knee arthroplasty. Our purpose was to establish a useful baseline for the kinematic envelope of knee motion in healthy older adults performing movements of daily living. A high-speed stereo radiography system was used to measure the three-dimensional tibiofemoral kinematics of eight healthy people over 55 yr of age (4 women/4 men; age, 61.7 ± 5.4 yr; body mass, 74.6 ± 7.7 kg; body mass index, 26.7 ± 4.4 kg·m−2; height, 168.2 ± 13.7 cm) during seated knee extension, level walking, pivoting, and step descent. Internal–external and varus–valgus rotation and anterior–posterior range of motion through stance in normal walking averaged 3.6° ± 1.1°, 2.3° ± 0.6°, and 3.4 ± 1.57 mm, respectively. Average range of motion across subjects was greater during the step-down in both internal–external rotation (average, 6.5° ± 3.1°) and anterior–posterior translation (average, 4.5 ± 1.1). Average internal–external range of motion increased to 13.5° ± 3.6° during pivoting. Range of motion of the knee in varus–valgus rotation was nearly the same for each subject across activities, rarely exceeding 6°. Pivoting and step descending during walking had greater internal–external rotation and anterior–posterior translation than normal gait. Internal–external rotation and anterior–posterior translation were shown to have greater activity dependence, whereas varus–valgus rotation was consistent across activities. These results were similar to prior measurements in younger cohorts, though a trend toward reduced range of motion in the older adults was observed.