Gait alterations to effectively reduce hip contact forces
Gait alterations to effectively reduce hip contact forces
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DOI：
10.1002/jor.22852
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发表时间：
2015-07-01
影响因子：
2.8
通讯作者：
Jonkers, Ilse
中科院分区：
文献类型：
--
作者：
Wesseling, Mariska;de Groote, Friedl;Jonkers, Ilse
髋关节病变患者的步态会发生变化，这会影响关节力矩和负荷。在膝关节骨关节炎患者中，内侧膝关节接触力和膝关节内收力矩之间的关系目前正被用于定义步态再训练策略，以有效减少疼痛和疾病进展。然而，髋关节接触力和关节力矩之间的关系尚未明确建立。因此，本研究旨在研究步态过程中髋关节和骨盆运动学变化对内部髋关节力矩和接触力的影响，这些力矩和接触力是使用肌肉驱动模拟计算的。结果表明，额面动力学对髋关节接触力的影响最大。考虑到髋内收力矩变化与初始站立时的接触力之间的高度相关性（R-2=0.87），该参数可用于改变运动学并预测接触力的变化。在终端站姿，髋关节内收和屈曲力矩可用于预测接触力的变化（R-2=0.76）。因此，侧重于减少髋关节内收力矩的步态训练（宽基础步态模式）具有减少髋关节接触力的最大潜力。(c)2015骨科研究学会。出版社：Wiley Periodicals，Inc. J Orthop Res 33：1094-1102，2015.
Patients with hip pathology present alterations in gait which have an effect on joint moments and loading. In knee osteoarthritic patients, the relation between medial knee contact forces and the knee adduction moment are currently being exploited to define gait retraining strategies to effectively reduce pain and disease progression. However, the relation between hip contact forces and joint moments has not been clearly established. Therefore, this study aims to investigate the effect of changes in hip and pelvis kinematics during gait on internal hip moments and contact forces which is calculated using muscle driven simulations. The results showed that frontal plane kinetics have the largest effect on hip contact forces. Given the high correlation between the change in hip adduction moment and contact force at initial stance (R-2=0.87), this parameter can be used to alter kinematics and predict changes in contact force. At terminal stance the hip adduction and flexion moment can be used to predict changes in contact force (R-2=0.76). Therefore, gait training that focuses on decreasing hip adduction moments, a wide base gait pattern, has the largest potential to reduce hip contact forces. (c) 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1094-1102, 2015.