新しい歩行解析による変形性膝関節症の関節動揺性および治療法の検討

本研究试图评估在站立行走早期突然发生的膝侧移，通常出现在膝关节骨关节炎患者的膝盖上，并研究各种类型的膝关节骨关节炎治疗的有效性。本研究得到以下结果：1。对加速度计传感器的解剖位置和固定方法影响的基础研究表明，最合适的位置是在腓骨头上方用胶带固定。2. 即使在同一个人的不同日期重复测量，也证实加速度计值具有足够的可重复性。3. 骨性关节炎膝关节可分为三种不同的加速度测量类型：1)侧向推力型，即足跟撞击后立即在外侧方向出现单一加速度峰值；2)内侧推力型，加速度出现在内侧方向；3)侧面峰和内侧峰同时出现的混合型。大多数内侧隔室骨关节炎表现为外侧推力型，而所有外侧隔室骨关节炎表现为内侧推力型。4. 横向加速度的峰值振幅随步行、上下斜坡或搬运重物的速度增加而显著增加。骨性关节炎患者的增加率明显高于正常膝关节。5. 峰值横向加速度显著降低与使用鞋垫有30毫米的楔形横向基础。另一方面，内侧加速峰明显减少与使用内侧增高鞋垫。骨关节炎膝与临床有效的鞋垫显示更大的减少峰值横向加速度比无效鞋垫。6. 内侧隔室性骨关节炎患者的侧推力模式在hi后转变为医学推力模式

This study attempted to evaluate a sideway movement of the knee which occures suddenly in the early stance phase of walking and usually present in knees in osteoarthritic knees, and also to investigate effectiveness of various types of treatment for osteoarthritice of the knee. Following results were obtained from this study : 1. Basic investigation on the effects of anatomical positions and methods of fixation of a senser of the accelerometer show that the most suitable site is over the fibular head fixed with adhesive tape. 2. Sufficient reproducibility was comfirmed in the accelerometric values even if the measurement was repearted on different dates for a same person. 3. Osteoarthritic knees were clasified into three different accelerometric types : 1) Lateral thrust type in which a single peak of acceleration appears in the lateral direction immediately after heel strike ; 2) Medial thrust type in which the acceleration appears in the medial direction ; and 3) Mixed type in which both lateral and medial peaks appears. Most knees with medial compartmental osteoarthritis shows lateral thrust type whereas all knees with lateral compartmental osteoarthritis show medial thrust type. 4. The peak amplitude of lateral acceleration was significantly increased with increased speed of walking, climbing up and down slopes, or ambulation carrying a heavy object. The rate of increase was significantly greater in osteoarthritic knees than in normal kennes. 5. The peak lateral acceleration was significantly reduced with the use of a shoe insole having thirty mm wedge base laterally. On the other hand, Medial acceleration peask was significantly reduced with the use of medially elevated shoe insole. Osteoarthritic knees with clinically effective insoles show greater reduction in the peak lateral acceleration than those with ineffective insoles. 6. The lateral thrust pattern observes in the medial compartmental osteoarthritic knees changed to the medical thrust pattern after hi