单侧膝骨关节炎对老年女性步态动力学和肌肉激活不对称性的影响  

Effect of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women

作　　者：李永杰 刘梦玲 张达宽 付申宇 刘洪举 Li Yongjie;Liu Mengling;Zhang Dakuan;Fu Shenyu;Liu Hongju(Department of Rehabilitation Medicine,Beijing Jishuitan Hospital Guizhou Hospital,Guiyang 550014,Guizhou Province,China)

机构地区：[1]北京积水潭医院贵州医院康复医学科,贵州省贵阳市550014

出　　处：《中国组织工程研究》2025年第27期5750-5756,共7页Chinese Journal of Tissue Engineering Research

基　　金：2023年度贵州省科技支撑计划(黔科合支撑[2023]一般179),项目负责人:刘洪举;2023年贵州省卫生健康委科学技术基金项目(gzwkj2023-124),项目负责人:付申宇。

摘　　要：背景:单侧膝骨关节炎患者下肢步态生物力学会发生异常改变,然而鲜有研究从步态不对称的角度分析膝骨关节炎患者步态动力学和肌肉激活的变化。目的:探索单侧膝骨关节炎对老年女性步态动力学和肌肉激活不对称性的影响。方法:选取2023年10月至2024年3月在北京积水潭医院贵州医院就诊的30例单膝患病的女性膝骨关节炎患者为膝骨关节炎组,并招募邻近社区无肌肉骨骼障碍的30例健康老年女性作为对照组。通过P-6000三维测力台和Free EMG300表面肌电设备同步采集两组受试者步行过程中的动力学和肌肉激活程度,动力学参数包括垂直地面反作用力的第一峰值和第二峰值,肌肉激活程度指标包括制动期和推动期股直肌、股二头肌长头以及腓肠肌外侧标准化的均方根值。分别计算K-L分级Ⅱ,Ⅲ级膝骨关节炎组患者和对照组受试者动力学和肌肉激活程度指标的不对称性指数,并通过独立样本t检验和单因素方差分析进行组间比较。结果与结论:①膝骨关节炎组患者两侧肢体垂直地面反作用力第二峰值之间差异有显著性意义(P<0.05),制动期股直肌和推动期腓肠肌外侧、股二头肌长头标准化均方根值之间的差异也有显著性意义(P<0.05);②在不对称性指数方面,两组受试者垂直地面反作用力第一峰值的不对称性指数差异无显著性意义(P>0.05),而第二峰值均方根值的差异有显著性意义(P<0.05);两组受试者制动期股直肌以及推动期腓肠肌外侧和股二头肌长头标准化均方根值的不对称性指数差异有显著性意义(P<0.05);③K-L分级Ⅱ级和Ⅲ级的膝骨关节炎组患者垂直地面反作用力第二峰值、制动期股直肌、推动期腓肠肌外侧和股二头肌长头标准化均方根值的不对称性指数均显著高于对照组(P<0.05),K-L分级Ⅲ级的膝骨关节炎组患者垂直地面反作用力第二峰值、制动期股直肌和推动期BACKGROUND:Unilateral knee osteoarthritis patients experience abnormal alterations in lower extremity gait biomechanics,yet few studies have analyzed changes in gait dynamics and muscle activation in knee osteoarthritis patients from the perspective of gait asymmetry.OBJECTIVE:To explore the effects of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women.METHODS:Thirty female patients with unilateral knee osteoarthritis attending Beijing Jishuitan Hospital Guizhou Hospital from October 2023 to March 2024 were selected as the knee osteoarthritis group,and 30 healthy elderly females without musculoskeletal disorders from the neighboring community were recruited as the control group.The kinetic and muscle activation levels of the subjects in both groups during walking were synchronously collected by a P-6000 force platform and a Free EMG300 surface EMG device.Kinetic parameters included the first and second peak forces of vertical ground reaction force.Muscle activation indexes included normalized root mean square values of rectus femoris,long head of biceps femoris,and lateral gastrocnemius muscle during the braking and pushing phases.Asymmetry index of the kinetic and muscle activation indexes were calculated separately in patients with K-L grade II and III knee osteoarthritis and controls and compared between groups by independent samples t-test and one-way analysis of variance.RESULTS AND CONCLUSION:(1)The difference between the second peak of vertical ground reaction force of both limbs in the knee osteoarthritis group was statistically significant(P<0.05),as well as the difference between the standardized root mean square of rectus femoris in the braking phase and gastrocnemius and biceps femoris in the pushing phase(P<0.05).(2)In terms of asymmetry index,the difference between the asymmetry index values of the first peak of vertical ground reaction force between the two groups of subjects was not statistically significant(P>0.05),while the difference between the sec

关 键 词：膝骨关节炎 动力学 表面肌电 不对称性 步态 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R684.3