Biomechanical adaptation to compensate balance recovery in people with knee osteoarthritis

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-26 DOI:10.1016/j.clinbiomech.2025.106475

Calum Downie , Pazit Levinger , Rezaul Begg

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引用次数: 0

Abstract

Background

Older adults with knee osteoarthritis are twice as likely to fall compared to healthy counterparts. Furthermore, in healthy older adults, greater trunk flexion is associated with increased falling. While spatio-temporal and strength measures have been connected to balance dysfunction in osteoarthritis, to date no studies have investigated compensation of both upper and lower body kinematics on balance recovery in this population.

Methods

Forty-eight older people with knee osteoarthritis (age 71.02 ± 6.76 years, 54 % females, BMI 29.10 ± 4.58) and 15 asymptomatic controls (age 72.47 ± 4.81, 27 % females, BMI 26.17 ± 3.06) completed balance recovery during a simulated forwards fall. Ankle, knee, hip, trunk and head kinematics were collected and analysed using three trial types (no additional, cognitive dual-task and physical dual-task). Two-way MANCOVA were conducted to identify group differences in ankle, knee, hip, and trunk angle, and head position (control and knee osteoarthritis), trial differences (no additional, cognitive and physical dual-task) and group by trial differences.

Findings

Postural differences in older adults with knee osteoarthritis included greater knee flexion (p = .02) and lower hip and trunk flexion (p < .01).

Interpretation

Following a simulated fall, older adults with knee osteoarthritis showed greater knee flexion at first contact which might suggest inability to resist forwards motion of the body.The more extended hip in this group and the resulting compensation of the upper body posture may lead to no difference in number of steps taken when compared to controls.

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膝关节骨关节炎患者的生物力学适应补偿平衡恢复

背景：患有膝骨关节炎的老年人跌倒的可能性是健康人的两倍。此外，在健康的老年人中，较大的躯干屈曲与摔倒的增加有关。虽然时空和力量测量与骨关节炎的平衡功能障碍有关，但迄今为止还没有研究调查了这一人群中上半身和下半身运动学对平衡恢复的补偿。方法48例老年膝关节骨性关节炎患者（年龄71.02±6.76岁，女性占54%，BMI为29.10±4.58）和15例无症状对照（年龄72.47±4.81，女性占27%，BMI为26.17±3.06）在模拟前跌倒过程中完成平衡恢复。采用三种试验类型（无附加、认知双任务和物理双任务）收集和分析踝关节、膝关节、髋关节、躯干和头部的运动学。进行双向MANCOVA以确定脚踝、膝关节、髋关节和躯干角度以及头部位置（对照和膝关节骨关节炎）的组间差异，试验差异（无额外的认知和身体双重任务）和试验组间差异。老年膝关节骨性关节炎患者的体位差异包括较大的膝关节屈曲（p = 0.02）和较低的髋部和躯干屈曲(p <；. 01)。在模拟跌倒后，患有膝关节骨性关节炎的老年人在第一次接触时表现出更大的膝关节屈曲，这可能表明无法抵抗身体向前运动。与对照组相比，该组中髋部伸展程度更高以及由此产生的上半身姿势补偿可能导致所采取的步数没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.