马凡氏综合征患者行走时髋关节力学的评估

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2025-05-01 DOI:10.1016/j.gaitpost.2025.04.036

Mariana V. Jacobs , Justin M. Pol , Aaron D. Fain , Jody L. Clasey , Brecca M.M. Gaffney , Christopher J. McLouth , Mary B. Sheppard , Michael A. Samaan

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引用次数: 0

摘要

马凡氏综合征（MFS）是一种常染色体显性结缔组织疾病，与肌肉功能障碍相关。与一般人群相比，MFS患者表现为股四头肌无力、髋关节疼痛和髋关节骨关节炎（OA）发生率增加，然而与这些不良髋相关结果相关的潜在生物力学因素尚不清楚。研究问题本研究的目的是评估MFS对步态力学的影响，并确定MFS组中步态力学与髋关节相关结果的关系。方法：对18名MFS患者和18名健康无症状对照者进行三维步态分析。所有研究参与者都完成了髋关节残疾和骨关节炎结局调查（HOOS），以获得患者报告的结果。(优点)。分别通过独立t检验、Kruskal-Wallis检验和多变量协方差分析分析组间人口统计学、HOOS评分和步态力学的差异，同时调整年龄。采用Spearman 's秩序相关来评估HOOS分值与动力学和运动学参数之间的关系。结果MFS组患者年龄明显大于对照组，骨盆矢状面、膝关节、踝关节运动学及踝关节动力学发生改变。MFS组的髋关节横平面运动范围、髋关节伸肌力矩脉冲（HEMI）、髋关节外展力矩峰值和髋关节外展力矩脉冲均较高。与对照组相比，MFS组也表现出更高的髋关节内旋力矩（HIRM）。MFS组也自我报告了更严重的髋关节相关PRO。在MFS组中，较高的HIRM和HEMI与更严重的髋关节相关疼痛和生活质量相关。这些结果表明，MFS患者行走时骨盆和下肢关节力学发生改变，这可能与MFS人群中较高的髋关节OA发生率和较差的髋关节相关PRO有关。

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Assessment of hip joint mechanics during walking in people with Marfan syndrome

Background

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder and is associated with muscle dysfunction. Individuals with MFS exhibit quadriceps weakness, hip joint pain, and an increased incidence of hip osteoarthritis (OA) compared to the general population, yet the underlying biomechanical factors associated with these poor hip-related outcomes are not well understood.

Research question

The purpose of this study was to assess the effects of MFS on gait mechanics and to determine the relationship of gait mechanics with hip-related outcomes within the MFS group. Methods: Eighteen people with MFS and 18 healthy, asymptomatic controls underwent 3D gait analysis. All study participants completed the Hip disability and Osteoarthritis Outcome Survey (HOOS) to obtain patient reported outcomes. (PROs). Between group differences in demographics, HOOS scores, and gait mechanics were analyzed via independent t-tests, a Kruskal-Wallis test, and a multi variate analysis of covariance while adjusting for age, respectively. A Spearman’s rank-order correlation was used to assess the relationship between HOOS sub-scores and kinetic and kinematic parameters.

Results

The MFS cohort was significantly older than the control cohort and ambulated with altered sagittal plane pelvis, knee and ankle kinematics as well as ankle kinetics. The MFS cohort ambulated with a higher hip transverse plane range of motion, hip extensor moment impulse (HEMI), peak hip abduction moments and hip abduction moment impulse. The MFS group also exhibited a higher hip internal rotation moment (HIRM) compared to the control group. The MFS cohort also self-reported worse hip-related PRO. Higher HIRM and HEMI were associated with worse hip-related pain and QOL within the MFS group.

Significance

These results suggest that people with MFS walk with altered pelvic and lower extremity joint mechanics which may be associated with the higher incidence rates of hip OA and poor hip-related PRO observed in the MFS population.

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.