膝骨关节炎患者步态中膝关节三维运动特征  

3D Knee Kinematics Characteristics during Gait Cycle of Patients with Knee Osteoarthritis

作　　者：杨晓露 张津沁 胡小卫 黄鹏[1] Yang Xiaolu;Zhang Jin-qin;Hu Xiaowei(Department of Sports Medicine and Rehabilitation Medicine,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学,北京100084 [2]中国人民解放军联勤保障部队第983医院康复医学科,天津300143 [3]中国康复研究中心北京博爱医院,北京100068 [4]杭州市江干区彭埠街道社区卫生服务中心,杭州310017

出　　处：《中国康复》2022年第2期90-94,共5页Chinese Journal of Rehabilitation

基　　金：中央高校基本科研业务费专项资金资助课题(2016RB009)。

摘　　要：目的:观察中老年膝关节骨关节炎(KOA)患者步态中膝关节的三维运动特征,为膝关节骨关节炎患者设计康复训练提供研究依据。方法:纳入符合标准的KOA患者29例为观察组;15例无KOA者纳入对照组。2组的年龄、身高、体重和身体质量指数(BMI)相匹配。2组受试者均使用KneeKG系统进行测量,对比自重状态下步行时两组受试者膝关节三维运动特征。结果:矢状面上观察组膝关节屈伸运动范围及摆动相时屈曲角度以及步行速度都明显小于对照组(P<0.05),但支撑相时屈膝角度明显较大(P<0.05)。额状面上观察组在足跟着地时内收角度明显大于对照组(P<0.05)。水平面上观察组在足跟着地时胫骨后移明显,胫骨相对股骨的旋转范围明显小于对照组(P<0.05)。结论:中老年膝关节骨关节炎患者膝关节呈现异常的锁扣机制,在矢状面上的活动较为僵硬,在额状面上的稳定性较差,同时胫骨相对股骨的旋转活动降低并有向后偏移的趋势。Objective:To observe the characteristics of 3 Dknee kinematics during gait cycle of elderly patients with knee osteoarthritis(KOA),and so as to provide reference for designing rehabilitation training for patients with KOA.Methods:Totally,29 patients with KOA served as the observation group and 15 people without KOA as the control group.The age,height,weight and body mass index(BMI)of the two groups were matched.The KneeKG system was used to measure the 3 Drange of motion of knees during walking under full weight bearing condition in both groups.Results:The knee flexion-extension range,knee flexion angle in swing phase and walking speed in the sagittal plane in the observation group were significantly reduced,but knee flexion angle was significantly increased in stance phase as compared with those in the control group(P<0.05).In the frontal plane,the adduction angle in the observation group was significantly larger than in the control group at heel strike(P<0.05).In the horizontal plane,the tibia in the observation group moved posterior obviously at heel strike,and the internal-external tibia rotation in the observation group was significantly smaller than in the control group(P<0.05).Conclusion:The elderly KOA patients presented abnormal screw-home mechanism.The motion in the sagittal plane was stiff and the stability in the frontal plane was lower;meanwhile,the internal-external tibia rotation decreased and the tibia tended to deviate posterior.

关 键 词：骨性关节炎 步态分析 膝关节 运动学特征 

分 类 号：R684.3[医药卫生—骨科学]