Bixuan Duan, Yuxuan Zhang, Pei Ma, Fangmin Chen, Wei Li
{"title":"运动恐惧对膝骨关节炎患者步态特征的影响。","authors":"Bixuan Duan, Yuxuan Zhang, Pei Ma, Fangmin Chen, Wei Li","doi":"10.1186/s12891-025-08920-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients.</p><p><strong>Methods: </strong>Cross-sectional data from 30 elderly patients with KOA (age 40-65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system.</p><p><strong>Results: </strong>In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SI<sub>norm</sub> of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SI<sub>norm</sub> of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SI<sub>norm</sub> of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01).</p><p><strong>Conclusion: </strong>High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. FOM can significantly affect patients' kinematic and kinetic parameters, especially PHIM and PKAM.Therefore, psychology-related interventions for treating KOA must be valued to improve patients' overall sports function and quality of life.</p><p><strong>Trial registration: </strong>The study was retrospectively registered on Chinese Trial Registry (PID: 246580).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"673"},"PeriodicalIF":2.2000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243228/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effect of fear of movement on gait characteristics in patients with knee osteoarthritis.\",\"authors\":\"Bixuan Duan, Yuxuan Zhang, Pei Ma, Fangmin Chen, Wei Li\",\"doi\":\"10.1186/s12891-025-08920-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients.</p><p><strong>Methods: </strong>Cross-sectional data from 30 elderly patients with KOA (age 40-65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system.</p><p><strong>Results: </strong>In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SI<sub>norm</sub> of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SI<sub>norm</sub> of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SI<sub>norm</sub> of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01).</p><p><strong>Conclusion: </strong>High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. 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引用次数: 0
摘要
背景：膝关节骨性关节炎（KOA）是一种高发于老年人群的疾病，给家庭和社会带来了沉重的负担。目的探讨KOA患者运动恐惧（FOM）与步态特征的关系。方法：采用30例老年KOA患者（40 ~ 65岁）的横断面资料。根据坦帕运动恐惧症量表（TSK-17）的辨别性问题（Q9）将他们分为高恐惧组（n = 15）和低恐惧组（n = 15）。另外，选取15名健康受试者作为对照组。所有参与者都被要求越过一个高度为腿长20%的障碍物。使用3D运动捕捉系统评估步态参数，包括髋关节、膝关节和踝关节的角度和两个下肢的力矩。结果：在组内比较中，高恐惧组正常侧与患侧在摇摆阶段膝关节屈曲角度（KFA, P = 0.04, ES = 0.70）、踝关节内收/外展峰值时刻（PAAM, P = 0.001, ES = 0.90）和膝关节内收/外展峰值时刻（PKAM, P = 0.006, ES = 0.97）方面存在差异。摆动期髋内外旋力矩峰值（phm, P = 0.005, ES = 0.87）和PKAM（HAA Pnorm, P = 0.003）存在差异。站立期PAAM SInorm （P = 0.004）、phm （P = 0.002）均高于高恐惧组。相关分析结果显示，TSK-17得分与PKAM SInorm呈显著正相关（r = 0.80， P）。结论：高恐惧性KOA患者可能采取保护性运动策略，减少患侧负重，导致运动模式不对称。FOM可显著影响患者的运动学和动力学参数，尤其是PHIM和PKAM。因此，必须重视治疗KOA的心理相关干预措施，以改善患者的整体运动功能和生活质量。试验注册：该研究在中国试验注册中心（PID: 246580）回顾性注册。
The effect of fear of movement on gait characteristics in patients with knee osteoarthritis.
Background: Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients.
Methods: Cross-sectional data from 30 elderly patients with KOA (age 40-65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system.
Results: In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SInorm of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SInorm of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SInorm of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01).
Conclusion: High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. FOM can significantly affect patients' kinematic and kinetic parameters, especially PHIM and PKAM.Therefore, psychology-related interventions for treating KOA must be valued to improve patients' overall sports function and quality of life.
Trial registration: The study was retrospectively registered on Chinese Trial Registry (PID: 246580).
期刊介绍：
BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.
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