Influences on knee movement strategies during walking in persons with medial knee Osteoarthritis
Influences on knee movement strategies during walking in persons with medial knee Osteoarthritis
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DOI：
10.1002/art.22889
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发表时间：
2007-08-15
期刊：
影响因子：
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通讯作者：
Rudolph, Katherine S.
中科院分区：
文献类型：
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作者：
Schmitt, Laura C.;Rudolph, Katherine S.
目标。探讨膝关节内侧骨性关节炎(OA)患者步行过程中的运动和肌肉激活策略，以确定股四头肌力量、膝关节内侧松弛、四肢对齐和自述膝关节不稳对膝关节运动的影响。28名膝关节内侧骨性关节炎患者和26名对照受试者参与研究。测量股四头肌力量、膝关节内侧松弛和四肢对齐。膝关节不稳定性(I-KOS评分)采用膝关节预后调查中的日常生活能力量表进行评定。通过运动分析测量膝关节运动和肌肉激活模式。组间差异用独立样本t检验进行检验，预测关系用线性和分层回归分析确定。患有骨性关节炎的患者身体较弱，膝关节内侧松弛较大，内翻对齐较多。在负重承重和单肢支撑期间，OA组使用较少的膝关节运动和较高的肌肉协同收缩。股四头肌力量和I-KOS评分显著加强了负重和单肢支撑时膝关节运动的预测，而肢体对齐和内侧松弛对膝关节运动的预测作用不明显。OA组使用的膝关节僵硬和更高的肌肉联合收缩可能会损害关节的完整性。I-KOS评分在考虑股四头肌力量后预测膝关节运动，强调了在膝关节内侧骨关节炎患者中采用适当的康复策略来解决膝关节不稳定性的重要性，以促进长期的关节完整性。
Objective. To investigate the movement and muscle activation strategies during walking of individuals with medial knee osteoarthritis (OA) to determine the influence of quadriceps strength, medial knee laxity, limb alignment, and self-reported knee instability on knee motion.Methods. Twenty-eight persons with medial knee OA and 26 control subjects participated. Quadriceps strength, medial knee laxity, and limb alignment were measured. Knee instability (I-KOS score) was assessed with the Activities of Daily Living Scale of the Knee Outcome Survey. Knee motion and muscle activation patterns were measured with motion analysis. Group differences were detected with independent samples t-tests and predictive relationships were determined with linear and hierarchical regression analyses.Results. Individuals with OA were weaker, had greater medial knee laxity, and had more varus alignment. The OA group used less knee motion and higher muscle co-contraction during weight acceptance and single-limb support. Quadriceps strength and I-KOS score significantly strengthened the prediction of knee motion during weight acceptance and single-limb support, whereas limb alignment and medial laxity did not.Conclusion. The knee stiffening and higher muscle co-contraction used by the OA group may be detrimental to joint integrity. I-KOS scores predicted knee motion after accounting for quadriceps strength, underscoring the importance of addressing knee instability with appropriate rehabilitation strategies in persons with medial knee OA in order to promote long-term joint integrity.