两种不同矫形器对早期内侧间室膝关节骨性关节炎步态的影响  

Effects of different orthoses on the gait in early stage medial compartment knee osteoarthritis

作　　者：张旻[1,2] 陈博[1,2] 江澜[3] 张晗[3] 董慧妹[3] 姚海昌[3] 詹红生[1,2] 

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海市浦东区201203 [2]上海市中医药研究院骨伤科研究所 [3]上海市第六人民医院康复医学科

出　　处：《中国康复医学杂志》2014年第1期26-30,46,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然基金项目(81173277;81072830);上海市科委重点科技攻关项目(11DZ1972902;11DZ1973402);上海市卫生局中药新药及院内制剂研发项目(2011ZJ007;2011ZJ012);上海市教育委员会科研创新项目(11YZ64;12YZ064)

摘　　要：目的:比较早期内侧间室膝关节骨性关节炎(OA)患者在佩戴膝关节外翻矫形器与外侧楔形角矫形鞋垫后所产生的下肢生物力学变化及差异,探讨不同矫形器在早期内侧间室膝关节骨性关节炎患者康复中的应用价值。方法:采用Vicon三维步态分析系统及Kislter测力台分别测评32例早期内侧间室型膝关节骨性关节炎患者在佩戴定制外侧楔形角矫形鞋垫(倾斜角5°)、膝关节外翻矫形器及无佩戴任何矫形器(测试期间均穿标准鞋)三种条件下的下肢关节运动学、动力学及时间空间参数。结果:相较于未佩戴任何矫形器情况,佩戴2种矫形器后膝关节内侧间室压力(膝关节内翻力矩,膝关节内翻角冲量)均明显降低(P<0.05),此外佩戴外侧楔形角矫形鞋垫后患者踝关节外翻角度明显增加,足底压力中心明显向外侧偏移(P<0.05)。结论:两种不同的矫形器均有助于降低早期内侧间室型膝关节骨性关节炎患者在步行过程中膝内侧间室所产生的压力,两者治疗效果未见明显差异。Objective： To compare the biomechanics changes at lower limb joints when early stage medial compartment knee osteoarthritis （OA） subjects wore the knee bracing and lateral wedges insole during walking, and to inves- tigate the clinical value of different orthoses in early stage medial compartment knee OA rehabilitation. Method： Thirty-two patents with early stage medial compartment knee OA were recruited from the rehabilita- tion department of Shanghai 6th Peoples＇ Hospital （China）. Kinen^atics, dynamics and temporal-spatial parame- ters were collected by Vicon 612 three dimensional gait analysis system and the kinetics changes were exam- ined by two Kislter force platforms at the same time under three conditions： （1）With a custom-made lateral wedge of 5°（in standard shoes）,（2）With a valgus knee bracing （in standard shoes）,（3）with control condition （in standard shoes）. Result： During wore both lateral wedge and knee bracing, the knee loading patterns （knee adduction moment and knee adduction angular impulse） at the knee joint decreased（P〈0.05）. The decreased loading on OA knee in wedge condition was associated with increasing of ankle valgus degrees and moment as well as laterally

关 键 词：生物力学 膝关节骨性关节炎 矫形器 步态分析 

分 类 号：R493[医药卫生—康复医学] R684[医药卫生—临床医学]