膝关节骨性关节炎的上升和下降任务的生物力学分析：来自前肢和后肢的见解。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2025.106436

Oliver Roberts , Tsung-Lin Wu , Phillis Teng , Jun Liang Lau , Yong Hao Pua , Ross A. Clark , Yi Hu , Bryan Yijia Tan

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引用次数: 0

摘要

背景：爬楼梯测试是评估膝关节骨关节炎患者体能表现的关键，然而，导致爬楼梯能力差的生物力学策略的报道各不相同。单步任务模拟一步一步的步态模式，一种与爬楼梯时膝盖疼痛有关的方法。本研究的目的是分析膝关节骨性关节炎患者在单次上台阶和下台阶时前肢和后肢的生物力学和肌电活动。方法：三维运动分析捕获了20名膝关节骨关节炎患者（n = 20）和24名年龄匹配的对照组（n = 24）完成孤立的Step-Up和Step-Down任务的生物力学数据。采用一维统计参数映射法对前后肢数据进行连续分析（α = 0.05）。研究结果：在升级过程中，膝关节骨性关节炎参与者表现出运动学(p)解释：我们的研究表明，膝关节骨性关节炎患者在单个升级和下降任务中表现出独特的生物力学策略，这些策略取决于骨关节炎膝关节是前伸还是后伸。单步任务比其他爬楼梯测试更安全、更实用。我们希望临床医生可以利用这些发现来指导治疗，促进晚期膝关节骨性关节炎患者减少步行和楼梯行走的工作量。

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Biomechanical analysis of step-up and step-down tasks in knee osteoarthritis: Insights from leading and trailing limbs

Background

Stair climbing tests are pivotal when assessing physical performance in knee osteoarthritis patients, yet the biomechanical strategies that underpin poor stair climbing ability are heterogeneously reported. Single step tasks emulate a step-by-step gait pattern, an approach associated with knee pain when stair climbing. The objective of this study is to analyse the biomechanics and electromyography activity of both the leading and trailing limbs during single Step-up and Down tasks in knee osteoarthritis patients.

Methods

Three-dimensional motion analysis captured biomechanical data of twenty participants with knee osteoarthritis (n = 20) and twenty four (n = 24) age matched controls completing isolated Step-Up and Step-Down tasks. Data was collected from both the leading and trailing limbs and analysed continuously using One-dimensional Statistical Parametric Mapping (α = 0.05).

Findings

During Step-Up, knee osteoarthritis participants demonstrated kinematic (p < 0.001), kinetic (p = 0.045), and electromyography (p < 0.001) variance compared to control participants, whilst Step-Down induced elevated external knee adduction moments (p = 0.042). Across both tasks, knee osteoarthritis participants stood with increased lower limb flexion in quiet standing and spent a proportionally elevated time in transitional double stance during Step-Up (p = 0.02).

Interpretation

Our study reveals that knee osteoarthritis patients display distinctive biomechanical strategies during single Step-Up and Down tasks, that deviate depending on whether the osteoarthritic knee is leading or trailing. Single-step tasks are a safer and practical alternative to other stair climbing tests. We hope that clinicians can use these findings to guide treatments that promote less effortful step and stair ambulation in knee osteoarthritis patients with advanced disease.

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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.