摘要
目的采用步态分析系统观察单侧慢性膝痛患者的步态特征,并寻找其特征参数与JOA评分间的相关性。方法选择2018年5月至2021年7月于安徽医科大学第二附属医院康复运动医学科因单侧慢性膝痛住院的患者20例(研究组),其中男性7例,女性13例;年龄33~81岁,平均年龄53.55岁;身高151~178 cm,平均身高162.45 cm;体质量52~82 kg,平均体质量62.50 kg。同期招募同等例数的健康人(对照组),其中男性9例,女性11例;年龄31~76岁,平均年龄52.15岁;身高154~182 cm,平均身高164.65 cm;体质量50~77 kg,平均体质量63.45 kg。通过Tecno Body Walkerview步态分析系统采集数据,比较两组人群步速、步长、触地时长、躯干屈伸活动度、躯干侧弯活动度,以及峰值屈髋角度、峰值屈膝角度,对采集的数据进行统计分析并分析JOA评分与研究组各指标间的相关性。结果研究组患侧步长、患侧触地时长较健侧明显减小,差异有显著统计学意义[(33.60±3.05)cm vs(40.10±2.67)cm、(0.83±0.05)s vs(0.93±0.04)s。t=-7.754、-6.336,P<0.01]。研究组步速、患侧步长、患侧触地时长较对照组均明显减低[(1.89±0.26)km/h vs(3.57±0.34)km/h、(33.60±3.05)cm vs(50.15±4.02)cm、(0.83±0.05)s vs(0.70±0.03)s],差异显著统计学意义(t=-17.572、-14.674、9.46,P<0.01)。研究组躯干屈伸活动度较对照组增大(7.52°±0.86°vs 2.48°±0.30°),差异具有显著统计学意义(t=24.697,P<0.01)。研究组躯干侧弯活动度较对照组增大(1.28°±0.43°vs 1.11°±0.31°),但差异无统计学意义(t=1.483,P=0.146)。研究组患侧峰值屈髋角度较健侧减少,差异有统计学意义[(21.45±2.13)°vs(22.84±1.53)°。t=-2.753,P<0.05];研究组患侧峰值屈膝角度较健侧明显减少,差异有显著统计学意义[(31.29±3.95)°vs(40.72±4.20)°。t=-6.748,P<0.01];研究组患侧峰值屈髋角度、患侧峰值屈膝角度均较对照组降低(21.45°±2.13°vs 27.58°±3.86°、31.29°±3.95°vs 49.14°±3.23°),差异有显著统计学意义(t=-6.22、-15.63,P<0.01)。JOA评分与步速(r=0.972,P<0.01)、患侧步长(r=0.865,P<0.01)、患侧触地时长(r=0.957,P<0.01)、患侧峰值屈膝角度(r=0.655,P<0.01)呈正相关,与躯干屈伸活动度呈负相关(r=-0.941,P<0.01),与躯干侧弯活动度、患侧屈髋角度无明显相关性。结论单侧慢性膝痛患者与正常人相比,步行能力、脊柱控制力下降,呈现异常行走步态。步速、患侧步长、患侧触地时长、躯干屈伸活动度、患侧峰值屈膝角度与JOA评分具有显著相关性,是评价慢性膝痛患者膝关节功能的重要参考指标。
Objective To observed gait characteristics of patients with unilateral chronic knee pain by gait analysis system,and study the correlation between characteristic parameters and Japanese Orthopedic Association(JOA) score. Methods From May 2018 to July 2021, 20 hospitalized patients with unilateral chronic knee pain(research group) were enrolled, which included7 males and 13 females, aged 33-81 years old with mean age of 53.55 years old;height was 151-178 cm with mean height of 162.45 cm;body mass was 52-82 kg with mean body mass of 62.50 kg. Meanwhile, 20 healthy subjects were set as control group, which included 9 males and 11 females, aged 31-76 years old with mean age of 52.15 years old;height was154-182 cm with mean height of 164.65 cm;body mass was 50-77 kg with mean body mass of 63.45 kg. The data was collected by Tecno Body Walker-view gait analysis system, and the pace, step length, touchdown time, trunk flexion-extension, trunk lateral bending activity, and peak hip flexion angle and peak knee flexion angle of 2 groups were compared. The collected data were statistically analyzed to study the correlation between JOA score and each index of research group. Results The step length and touchdown time of injured side in research group were significantly shorter than those of healthy side, and the differences were statistically significant[(33.60 ± 3.05) cm vs(40.10 ± 2.67) cm,(0.83 ± 0.05) seconds vs(0.93 ± 0.04) seconds. t =-7.754,-6.336, P < 0.01]. The gait speed, injured step length and touchdown time in research group were significantly lower than those in control group[(1.89 ± 0.26) km/h vs(3.57 ± 0.34) km/h,(33.60 ± 3.05) cm vs(50.15 ± 4.02) cm,(0.83 ± 0.05) seconds vs(0.70 ±0.03) seconds], and differences were statistically significant(t =-17.572,-14.674, 9.46, P < 0.01). The trunk flexion and extension activity in research group was significantly higher than that in control group(7.52° ± 0.86° vs 2.48° ± 0.30°), and difference was statistically significant(t = 24.697, P < 0.01). The activity of trunk lateral bending in research group was higher than that in control group(1.28° ± 0.43° vs 1.11° ± 0.31°), while the difference was not statistically significant(t = 1.483, P = 0.146). The peak hip flexion angle of injured side was lower than that of healthy side in research group, and the difference was statistically significant[(21.45 ± 2.13)° vs(22.84 ± 1.53)°. t =-2.753, P < 0.05];The peak knee flexion angle of injured side was significantly lower than that of healthy side in research group, and the difference was statistically significant[(31.29 ± 3.95)° vs(40.72 ± 4.20)°. t =-6.748,P < 0.01];The injured peak hip flexion angle and peak knee flexion angle in research group were lower than those in control group(21.45° ± 2.13° vs 27.58 °± 3.86°, 31.29° ± 3.95° vs 49.14° ± 3.23°), and the differences were statistically significant(t =-6.22,-15.63, P < 0.01). JOA score was positively correlated with step speed( r = 0. 972, P < 0. 01), injured side step length(r =0.865, P < 0.01), injured side touchdown time(r = 0.957, P < 0.01), injured side peak knee flexion angle(r = 0.655, P < 0.01),negatively correlated with trunk flexion and extension activity(r =-0.941, P < 0.01), but not correlated with trunk lateral flexion activity and hip flexion angle of injured side. Conclusion It is demonstrated that gait ability and spinal control of patients with unilateral chronic knee pain are lower than those of normal. The gait speed, step length, touchdown time, trunk flexion and extension activity, peak knee flexion angle of injured side are significantly correlated with JOA score, which are important reference indexes for evaluating knee function in patients with chronic knee pain.
作者
丁呈彪
刘奕
冯小军
王原莉
张海洋
刘龙康
王华
周云
DING Cheng-biao;LIU Yi;FENG Xiao-jun;WANG Yuan-li;ZHANG Hai-yang;LIU Long-kang;WANG Hua;ZHOU Yun(Department of Rehabilitation Medicine,The Second Hospital of Anhui Medical University,Hefei 230601f Anhui,China;Anhui Medical University,Second Clinical Medical College,Hefei 230601,Anhui,China;Department of Hygienic Toxicology,School of Public Health,Anhui Medical University^Hefei 230032,Anhui,China)
出处
《生物医学工程与临床》
CAS
2022年第3期290-294,共5页
Biomedical Engineering and Clinical Medicine
基金
2019年度安徽医科大学校科研基金项目(2019xkj036)
安徽省高等学校省级质量工程项目(2019jyxm0999)
2020年度国家级大学生创新创业项目(202010366054)
2021康复运动医学与卫生毒理学共建项目(2021lcxk031)
安徽省高等学校省级质量工程项目(2020jyxm0903)
安徽省重点研发计划(202004j07020040)。
关键词
慢性膝痛
步态分析
JOA评分
相关性分析
chronic knee pain
gait analysis
Japanese Orthopedic Association(JOA)score
correlation analysis
