膝骨关节炎患者30例步态分析研究

Gait analysis of thirty patients with knee osteoarthritis

目的研究膝骨关节炎(KOA)患者步态变化, 为通过步态学分析所获量化性指标诊断KOA提供理论基础, 对KOA的临床诊疗、康复、预防及疗效评价提供步态学参考。方法收集山西医科大学第二医院2021年5月至10月住院的双膝KOA患者30例(KOA组), 同期本院健康体检者30名(健康对照组), 予以量表评分、足底压力参数、时空参数、运动学参数检测, 对比研究KOA患者步态学变化。组间差异性比较采用t检验、Mann-WhitneyU检验及Fisher精确检验。结果 KOA组客观步态学指标中步长时间[(642±81)ms和(548±62)ms, t=-5.01, P<0.001]、步行周期[(1 284±168)ms和(1 076±114)ms, t=-5.61, P<0.001]、双支撑时间[(531±125)ms和(331±51)ms, t=-8.10, P<0.001]、双支撑时间周期占比(0.417±0.063和0.309±0.023, t=-8.50, P<0.001)、总支撑时间[(914±135)ms和(678±107)ms, t=-7.52, P<0.001]、总支撑时间周期占比(0.711±0.027和0.627±0.044, t=-8.87, P<0.001)、左静态站立(55.7±8.4和51.5±2.3, t=-2.65, P=0.012)均较健康对照组高, 差异均有统计学意义;KOA组单支撑时间周期占比(0.287±0.030和0.334±0.013, t=7.80, P<0.001)、右静态站立(44.3±8.4和48.5±2.3, t=2.65, P=0.012)、步长[(36±8)cm和(52±5)cm, t=9.97, P<0.001]、跨步长[(70±16)cm和(103±8)cm, t=10.00, P<0.001]、步速[(0.60±0.18)m/s和(1.05±0.19), t=9.54, P<0.001]、左膝关节矢状位活动范围[(42±17)°和(63±4)°, t=6.49, P<0.001]、右膝关节矢状位活动范围[(37±18)°和(62±3)°, t=7.54, P<0.001]均较健康对照组低, 差异均有统计学意义。结论步态分析可对KOA患者进行量化评价, 使KOA的诊断方法从定性到客观的定量指标诊断成为可能。

Objective By studying the gait changes of patients with knee osteoarthritis(KOA),the study provided a theoretical basis for the quantitative indicators obtained from gait analysis to the diagnosis of KOA.And it provided a gait reference for the clinical diagnosis,treatment,rehabilitation,prevention and efficacy evaluation of KOA.Methods A total of 30 patients(KOA group)with KOA hospitalized in our hospital from May 2021 to October 2021 and 30 healthy people(control group)were compared for gait changes.The t test,Mann-Whitney U test and Fisher′s exact test were used to compare differences between groups.Results The KOA group were greater than the control group in terms of step time[(642±81)ms and(548±62)ms,t=-5.01,P<0.001],gait cycle[(1284±168)ms and(1076±114)ms,t=-5.61,P<0.001],double support time[(531±125)ms and(331±51)ms,t=-8.10,P<0.001],double support time period proportion(0.417±0.063 and 0.309±0.023,t=-8.50,P<0.001),total support time[(914±135)ms and(678±107)ms,t=-7.52,P<0.001],total support time period proportion(0.711±0.027 and 0.627±0.044,t=-8.87,P<0.001),and left static standing time(55.7±8.4 and 51.5±2.2,t=-2.65,P=0.012),for which the differences were statistically significant.The KOA group were lower than the control group in terms of single support time period proportion(0.287±0.030 and 0.334±0.013,t=7.80,P<0.001),right static standing time(44.3±8.4 and 48.5±2.3,t=2.65,P=0.012),step length[(36±8)cm and(52±5)cm,t=9.97,P<0.001],stride length[(70±16)cm and(103±8)cm,t=10.00,P<0.001],velocity[(0.60±0.18)m/s and(1.05±0.19)m/s,t=9.54,P<0.001],left knee range of motion[(42±17)°and(63±4)°,t=6.49,P<0.001],and right knee range of motion[(37±18)°and(62±3)°,t=7.54,P<0.001],for which the differences were statistically significant.Conclusion Gait analysis can quantitatively evaluate the condition of patients with KOA,making it possible to transform the diagnostic criteria of KOA from qualitative to quantitative.