Multi-joint biomechanics during sloped walking in patients with developmental dysplasia of the hip.
Multi-joint biomechanics during sloped walking in patients with developmental dysplasia of the hip.
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DOI：
10.1016/j.clinbiomech.2021.105335
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Harris MD
中科院分区：
文献类型：
--
作者：
Gaffney BMM;Van Dillen LR;Foody JN;Burnet PE;Clohisy JC;Chen L;Harris MD
发育性髋关节发育不良的特征是髋臼和股骨几何结构异常，改变了关节负荷，增加了髋关节骨关节炎的风险。目前对该人群生物力学的理解仍然局限于髋关节，主要集中在平地行走，这可能无法捕获导致症状和关节内损伤的可变载荷条件。30名年轻成年女性（15名发育不良）在水平、10°倾斜和10°倾斜行走过程中进行步态分析，同时记录全身运动学、地面反作用力和肌电图（EMG）。使用15段模型计算下背部、髋关节和膝关节运动学和内部关节力矩，并在步态的功能阶段内计算综合EMG。采用单因素ANOVA比较各组间的因变量（峰值关节运动学、力矩和积分EMG），并使用Benjamini-Hochberg方法（α = 0.05）控制多重比较。在水平和倾斜行走时，发育性髋关节发育不良患者的躯干屈曲角度、腰和膝伸肌力矩以及竖脊肌活动均显著低于对照组。髋关节发育不良的患者也表现出减少股直肌活动水平行走期间的负载和增加臀大肌活动在中期的立场下降行走。发育性髋关节发育不良的患者在髋关节近端和远端均采用补偿，这取决于行走的坡度。深入了解多关节的生物力学补偿机制，对于理解骨关节炎的发生机制和继发性疾病具有重要意义。
Developmental dysplasia of the hip is characterized by abnormal acetabular and femoral geometries that alter joint loading and increase the risk of hip osteoarthritis. Current understanding of biomechanics in this population remains isolated to the hip and largely focused on level-ground walking, which may not capture the variable loading conditions that contribute to symptoms and intra-articular damage. Thirty young adult females (15 with dysplasia) underwent gait analysis during level, 10° incline, and 10° decline walking while whole-body kinematics, ground reaction forces, and electromyography (EMG) were recorded. Low back, hip, and knee joint kinematics and internal joint moments were calculated using a 15-segment model and integrated EMG was calculated within the functional phases of gait. Dependent variables (peak joint kinematics, moments, and integrated EMG) were compared across groups with a one-way ANOVA with multiple comparisons controlled for using the Benjamini-Hochberg method (α = 0.05). During level and incline walking, patients with developmental dysplasia of the hip had significantly lower trunk flexion angles, lumbar and knee extensor moments, and erector spinae activity than controls. Patients with developmental dysplasia of the hip also demonstrated reduced rectus femoris activity during loading of level walking and increased gluteus maximus activity during mid-stance of decline walking. Patients with developmental dysplasia of the hip adopt compensations both proximal and distal to the hip, which vary depending on the slope of walking. Furthering the understanding of multi-joint biomechanical compensations is important for understanding the mechanism of osteoarthritis development as well as secondary conditions.
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DOI：
10.1136/fn.76.2.f94
发表时间：
1997-03-01
影响因子：
4.4
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DOI：
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发表时间：
2003-12-01
影响因子：
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