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Treatment effect for knee osteoarthritis detected by early dynamic changes of knee joint movement during gait

通过步态中膝关节运动早期动态变化检测膝骨关节炎的治疗效果

基本信息

批准号：
21300206
负责人：
AKAI Masami
金额：
$ 11.9万
依托单位：
National Rehabilitation Center for Persons with Disabilities
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

项目摘要

We, Japanese have nearly seven million patients with symptomatic knee osteoarthritis, who are often indicated with conservative treatments like quadriceps strengthening or foot insoles. Osteoarthritis patients may exhibit different kinematics according to the stage of disease, however, the pathomechanism of such treatments is still uncertain. The purpose of this study was to investigate changes in the knee kinematic gait variables of osteoarthritis patients, including the frontal and horizontal planes, with respect to the severity of the disease.All subjects were examined their gait patterns during walking on a flat walkway. In each trial, we calculated the angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation. We also measured muscle strength, range of motion(ROM), and ground reaction force(GRF). We compared the differences in osteoarthritis severity and knee kinematic variables in the frontal and horizontal planes between osteoarthritis patients and normal subjects.Osteoarthritis patients had different knee kinematics during gait, depending on the progress of osteoarthritis. Early-stage patients mainly exhibited decreased axial tibial rotation excursion, while severe-stage patient exhibit increased knee adduction. In the third year, we added a new device which can produce sudden floor perturbation to simulate a clinical situation, and ultrasound therapy for analgesic effect to separate factors from knee alignment and from pain. We continue the investigation to understand the pathomechanism and prognosis of knee osteoarthritis.

我们日本有近700万有症状的膝关节骨关节炎患者，他们经常接受保守治疗，如股四头肌加强或鞋垫。骨关节炎患者可能会表现出不同的运动学根据疾病的阶段，然而，这种治疗的病理机制仍然是不确定的。本研究的目的是调查膝关节骨性关节炎患者的膝关节运动学步态变量的变化，包括正面和水平面，相对于疾病的严重程度。在每次试验中，我们计算了屈曲/伸展、外展/内收和胫骨外旋/内旋的角位移。我们还测量了肌肉力量，运动范围（ROM）和地面反作用力（GRF）。我们比较了骨关节炎患者和正常人之间骨关节炎严重程度和膝关节运动学变量在额面和水平面上的差异。骨关节炎患者在步态中具有不同的膝关节运动学，这取决于骨关节炎的进展。早期患者主要表现为胫骨轴向旋转偏移减少，而重度患者则表现为膝关节内收增加。在第三年，我们增加了一个新的设备，可以产生突然的地板扰动，以模拟临床情况，和超声治疗的镇痛效果，以分离因素，从膝关节对齐和疼痛。我们将继续研究以了解膝骨关节炎的病理机制和预后。