| 张旻,马峥,江澜,张晗,陈博,郭海玲,陈东煜,赵永芳,詹红生.不同外侧楔形矫形鞋垫对内侧间室膝骨性关节炎患者步态的影响[J].中国康复,2015,30(1):61-64 |
| 不同外侧楔形矫形鞋垫对内侧间室膝骨性关节炎患者步态的影响 |
| Effects of different types of lateral wedges on gait in patients with medial compartment knee osteoarthritis |
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| DOI： |
| 中文关键词: 生物力学 膝骨性关节炎 外侧楔形角矫形鞋垫 步态分析 |
| 英文关键词: biomechanics knee osteoarthritis lateral wedges gait analysis |
| 基金项目:上海中医药大学预算内项目（2014JW47） |
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| 中文摘要: |
| 目的:通过比较早期内侧间室膝骨性关节炎患者在佩戴传统与新型外侧楔形角矫形鞋垫(LW)后步行过程中所产生的下肢生物力学变化及差异，探讨新型设计的LW在早期内侧间室骨关节炎康复治疗中的应用价值。方法:采用英国Vicon三维步态分析系统配合Kislter测力台分别测评30例早期内侧间室型膝骨性关节炎患者在佩戴传统LW（楔形角5°）、新型带足弓支撑的LW（楔形角5°）及无佩戴任何矫形器（测试过程中均穿标准鞋）3种不同条件下的下肢关节运动学、动力学及时间空间参数变化。结果: 相较于未佩戴任何矫形鞋垫情况，佩戴2种LW后膝关节载荷（膝关节内翻力矩，膝关节内翻角冲量）均显著降低（P<0.05）。此外，佩戴传统的LW后患者步行过程中踝关节外翻角度、外翻力矩及地面反作用力内侧方向较其他2种方式明显增加（P<0.05），而佩戴新型LW后下肢前进角度较其他2种方式显著增加（P<0.05）。结论:两种不同设计的LW均有助于缓解早期内侧间室型膝骨性关节炎患者运动过程中的膝关节载荷，且未见明显差异。但相较于传统外侧楔形矫形鞋垫，带有足弓支撑设计的矫形鞋垫佩戴后更为舒适，且不会引起踝关节内侧应力的增加。 |
| 英文摘要: |
| Objective: To investigate the biomechanics changes at lower limb joints of patients with early stage medial compartment knee osteoarthritis (OA) wearing different types of lateral wedges during walking, and to define which type of lateral wedge is potentially more suitable in the treatment of the medial compartment knee OA. Method: Thirty patients with early stage medial compartment knee OA were enrolled. Both kinematics and temporal parameters were examined by Vicon 612 3-Dimensional gait analysis system and the kinetics changes were tested by two Kislter force platforms at the same time under three conditions: a custom-made traditional lateral wedge of 5° (with standard shoes), a custom-made arch supported lateral wedges of 5° (with standard shoes), control condition (standard shoes only). Results: Both two types of lateral wedges showed significantly decreased knee joints loading (knee adduction moment and knee adduction angular impulse) (P<0.05). The decreased loading on OA knees in traditional wedges condition was associated with an increased ankle valgus degrees, moment and medial group reaction force when compared to the control and arch supported conditions (P<0.05), and the arch supported lateral wedges showed an increased foot progression angles (P<0.05). Conclusion: The results showed that under dynamic condition, both two wedges showed decreased loading in the medial compartment at knees, and the arch supported wedges were found to be more comfortable and did not cause high loading in the ankle. |
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