切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (06) : 806 -813. doi: 10.3877/cma.j.issn.1674-134X.2018.06.012

所属专题: 文献

综述

步态分析在膝关节疾病中的应用
刘日许1, 陈艺1, 陈玉书1, 邹健宇1, 郑仕聪1, 白波1,()   
  1. 1. 510120 广州医科大学附属第一医院骨科,广东省骨科矫形技术与植入材料重点实验室
  • 收稿日期:2018-02-26 出版日期:2018-12-01
  • 通信作者: 白波

Gait analysis in knee diseases

Rixu Liu1, Yi Chen1, Yushu Cheng1, Jianyu Zou1, Shicong Zheng1, Bo Bai1,()   

  1. 1. Department of Orthopedic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Orthopedic Technology and Implant Materials of Guangdong Province, Guangzhou 510120, China
  • Received:2018-02-26 Published:2018-12-01
  • Corresponding author: Bo Bai
  • About author:
    Corresponding author: Bai Bo, Email:
引用本文:

刘日许, 陈艺, 陈玉书, 邹健宇, 郑仕聪, 白波. 步态分析在膝关节疾病中的应用[J/OL]. 中华关节外科杂志(电子版), 2018, 12(06): 806-813.

Rixu Liu, Yi Chen, Yushu Cheng, Jianyu Zou, Shicong Zheng, Bo Bai. Gait analysis in knee diseases[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(06): 806-813.

步态分析是定量评估步态障碍的有效工具,包括:提供功能诊断、治疗计划评估和疾病进展监测。其目的可以分为3个不同的类别,包括:描述特定人群的步态模式、对特定人群的功能严重程度进行评估分类和评估特定治疗干预的效果。本文通过文献整理分析发现:膝关节疾病步态分析研究主要集中在膝关节炎、前交叉韧带损伤与重建、半月板损伤及修复等方面。因此本文系统汇总了近几年国内外对上述及其它膝关节疾病步态分析的相关文献,总结了近几年来关于该研究范畴的最新进展。

Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress.The aims of gait analysis can be divided into three different categories: to characterize the gait pattern of a certain population, to classify and categorize the functional severity of a certain population and to evaluate the effect of a given intervention. This article briefly introduced the latest progresses of gait analysis in knee diseases including knee arthritis, anterior cruciate ligament injury and reconstruction, meniscus injury repair and so on.

[1]
Baker R, Esquenazi A, Benedetti MG et al. Gait analysis: clinical facts[J/OL]. Eur J Phys Rehabil Med, 2016,52(4):560-574.
[2]
Sutherland DH. The evolution of clinical gait analysis part l: kinesiological EMG[J]. Gait Posture, 2001, 14(1):61-70.
[3]
Sutherland DH. The evolution of clinical gait analysis. Part II kinematics[J]. Gait Posture, 2002, 16(2):159-179.
[4]
Sutherland DH. The evolution of clinical gait analysis part III-kinetics and energy assessment[J]. Gait Posture,2005, 21(4):447-461.
[5]
King RC, Villeneuve E, White RJ, et al. Application of data fusion techniques and technologies for wearable health monitoring[J]. Med Eng Phys, 2017, 42(42): 1-12.
[6]
Taş S, Güneri S, Kaymak B, et al. A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis[J/OL]. Acta Orthop Traumatol Turc, 2015, 49(2):151-159. doi: 10.3944/AOTT.2015.14.0158.
[7]
Debi R, Elbaz A, Mor A, et al. Knee osteoarthritis, degenerative meniscal lesion and osteonecrosis of the knee: can a simple gait test direct us to a better clinical diagnosis[J]. Orthop Traumatol Surg Res, 2017, 103(4): 603-608.
[8]
Mannoni A, Briganti MP, Di Bari M, et al. Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy[J]. Ann Rheum Dis, 2003, 62(6): 576-578.
[9]
Peat G, Mccarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care[J]. Ann Rheum Dis, 2001, 60(2): 91-97.
[10]
Bennell KL, Wrigley TV, Hunt MA, et al. Update on the role of muscle in the Genesis and management of knee osteoarthritis[J/OL]. Rheum Dis Clin North Am, 2013, 39(1):145-176. doi: 10.1016/j.rdc.2012.11.003.
[11]
Astephen JL, Deluzio KJ, Caldwell GE, et al. Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels[J]. J Biomech, 2008, 41(4): 868-876.
[12]
Huang SC, Wei IP, Chien HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis[J]. Med Eng Phys, 2008, 30(8, SI): 997-1003.
[13]
Sun J, Liu YC, Yan SH, et al. Clinical gait evaluation of patients with knee osteoarthritis[J]. Gait Posture, 2017, 58(58): 319-324.
[14]
Anatole, Vilhelm, Wiik, et al. Abnormal ground reaction forces Lead to a general decline in gait speed in knee osteoarthritis patients[J]. World J Orthop, 2017, 8(4): 322-328.
[15]
Marcum ZA, Zhan HL, Perera S, et al. Correlates of gait speed in advanced knee osteoarthritis[J/OL]. Pain Med, 2014, 15(8):1334-1342. doi: 10.1111/pme.12478.
[16]
Caravaggi P, Savage R. New insights into the plantar pressure correlates of walking speed using pedobarographic statistical parametric mapping(pSPM)[J/OL]. J Biomech, 2008, 41(9):1987-1994. doi: 10.1016/j.jbiomech.2008.03.034.
[17]
Creaby MW, Bennell KL, Hunt MA. Gait differs between unilateral and bilateral knee osteoarthritis[J]. Arch Phys Med Rehabil, 2012, 93(5): 822-827.
[18]
Fernandes WC, Machado A, Borella CA. Influence of gait speed on plantar pressure in subjects with unilateral knee osteoarthritis[J]. Rev Bras Reumatol, 2014, 54(6): 441-445.
[19]
Phinyomark A, Osis ST, Hettinga BA, et al. Gender differences in gait kinematics for patients with knee osteoarthritis[J/OL]. BMC Musculoskelet Disord. 2016, 17:157. doi: 10.1186/s12891-016-1013-z.
[20]
Paterson KL, Sosdian L, Hinman RS, et al. The influence of sex and obesity on gait biomechanics in people with severe knee osteoarthritis scheduled for arthroplasty[J/OL]. Clin Biomech (Bristol, Avon), 2017, 49:72-77. doi: 10.1016/j.clinbiomech.2017.08.013.
[21]
Mahmoudian A, Van Dieen JH, Baert IA, et al. Changes in gait characteristics of women with early and established medial knee osteoarthritis: results from a 2-years longitudinal study[J/OL]. Clin Biomech (Bristol, Avon), 2017, 50:32-39. doi: 10.1016/j.clinbiomech.2017.10.004.
[22]
O′Connell M, Farrokhi S, Fitzgerald GK. The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis [J/OL]. Clin Biomech (Bristol, Avon), 2016, 31:40-46. doi: 10.1016/j.clinbiomech.2015.10.003.
[23]
Taş S, Güneri S, Baki A, et al. Effects of severity of osteoarthritis on the temporospatial gait parameters in patients with knee osteoarthritis[J]. Acta Orthop Traumatol Turc, 2014, 48(6): 635-641.
[24]
Zeng XL, Ma LM, Lin ZF, et al. Relationship between Kellgren-Lawrence score and 3D kinematic gait analysis of patients with medial knee osteoarthritis using a new gait system[J/OL]. Sci Rep, 2017, 7(1):4080. doi: 10.1038/s41598-017-04390-5.
[25]
Park SK, Kobsar D, Ferber R. Relationship between lower limb muscle strength, self-reported pain and function, and frontal plane gait kinematics in knee osteoarthritis[J/OL]. Clin Biomech (Bristol, Avon), 2016, 38:68-74. doi: 10.1016/j.clinbiomech.2016.08.009.
[26]
Robbins SM, Birmingham TB, Jones IC, et al. Comparison of gait characteristics between patients with nontraumatic and posttraumatic medial knee osteoarthritis[J]. Arthritis Care Res (Hoboken), 2016, 68(9): 1215-1223.
[27]
Otani T, Takeda K. Anterior cruciate ligament Reconstruction does not fully restore normal 3D knee kinematics at 12 months during walking and Walk-Pivoting:A longitudinal gait analysis study[J/OL]. J Appl Biomech, 2015, 31(5):330-339. doi: 10.1123/jab.2014-0175.
[28]
Bytyqi D, Lustig S. Gait changes of the ACL-deficient knee 3D kinematic assessment[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11):3259-3265. doi: 10.1007/s00167-014-3169-0.
[29]
Amri S, Roohi S. Assessment of gait symmetry improvements in national athletes after anterior cruciate ligament reconstruction during rehabilitation[J/OL]. Int J Sports Med, 2016, 37(12):997-1002.
[30]
Majewska J, Szczepanik M, Szymczyk D, et al. Evaluation of selected gait parameters in patients prior to and at 6 months following early anterior cruciate ligament reconstruction[J]. Orthop Traumatol Rehabil, 2017, 19(3): 273-283.
[31]
Erhart-Hledik JC, Chu CR, Asay JL, et al. Longitudinal changes in knee gait mechanics between 2 and 8 years after anterior cruciate ligament Reconstruction[J/OL]. J Orthop Res, 2018, 36(5): 1478-1486. doi: 10.1002/jor.23770.
[32]
Shi DL, Li NN, Wang YB, et al. Gait modification strategies of trunk over left stance phase in patients with right anterior cruciate ligament deficiency[J]. Int J Clin Exp Med, 2015, 8(8): 13424-13434.
[33]
Sigward SM, Lin PG, Pratt K. Knee loading asymmetries during gait and running in early rehabilitation following anterior cruciate ligament reconstruction: a longitudinal study[J/OL]. Clin Biomech (Bristol, Avon). 2016, 32:249-254. doi: 10.1016/j.clinbiomech.2015.11.003.
[34]
Hadizadeh M, Amri S, Mohafez H, et al. Gait analysis of national athletes after anterior cruciate ligament reconstruction following three stages of rehabilitation program: symmetrical perspective[J]. Gait Posture, 2016, 48(48): 152-158.
[35]
Hewett TE, Myer GD, Ford KR, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes:a prospective study[J/OL]. Am J Sports Med, 2005, 33(4):492-501.
[36]
Di Stasi S, Hartigan EH, Snyder-Mackler L. Sex-specific gait adaptations prior to and up to 6 months after anterior cruciate ligament reconstruction[J/OL]. J Orthop Sports Phys Ther, 2015, 45(3):207-214. doi: 10.2519/jospt.2015.5062.
[37]
Asaeda M, Deie M, Fujita N, et al. Gender differences in the restoration of knee joint biomechanics during gait after anterior cruciate ligament reconstruction[J]. Knee, 2017, 24(2): 280-288.
[38]
Milandri G, Posthumus M, Small TJ, et al. Kinematic and kinetic gait deviations in males long after anterior cruciate ligament Reconstruction[J/OL]. Clin Biomech (Bristol, Avon), 2017, 49:78-84. doi: 10.1016/j.clinbiomech.2017.07.012.
[39]
Capin JJ, Khandha A, Zarzycki R, et al. Gait mechanics and second ACL rupture: Implications for delaying return-to-sport[J/OL]. J Orthop Res, 2017, 35(9):1894-1901. doi: 10.1002/jor.23476.
[40]
Webster KE, Wittwer JE, O′brien J, et al. Gait patterns after anterior cruciate ligament Reconstruction are related to graft type[J]. Am J Sports Med, 2005, 33(2): 247-254.
[41]
Abourezk MN, Ithurburn MP, Mcnally MP, et al. Hamstring strength asymmetry at 3 years after anterior cruciate ligament Reconstruction alters knee mechanics during gait and jogging[J/OL]. Am J Sports Med,2017, 45(1):97-105. doi: 10.1177/0363546516664705.
[42]
Schliemann B, Glasbrenner J, Rosenbaum DA, et al. Changes in gait pattern and early functional results after ACL repair are comparable to those of ACL reconstruction[J/OL]. Knee Surg Sports Traumatol Arthrosc,2018, 26(2):374-380. doi: 10.1007/s00167-017-4618-3.
[43]
Nicolas R, Nicolas B, François V, et al. Comparison of knee kinematics between meniscal tear and normal control during a step-down task[J/OL]. Clin Biomech (Bristol, Avon), 2015, 30(7):762-764. doi: 10.1016/j.clinbiomech.2015.05.012.
[44]
Harato K, Sakurai A, Kudo Y, et al. Three-dimensional knee kinematics in patients with a discoid lateral meniscus during gait[J]. Knee, 2016, 23(4): 622-626.
[45]
Edd SN, Netravali NA, Favre J, et al. Alterations in knee kinematics after partial medial meniscectomy are activity dependent[J/OL]. Am J Sports Med, 2015, 43(6):1399-1407. doi: 10.1177/0363546515577360.
[46]
Thorlund JB, Holsgaard-Larsen A, Creaby M, et al. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy: a prospective cohort study[J/OL]. Osteoarthritis Cartilage, 2016, 24(7): 1153-1159. doi: 10.1016/j.joca.2016.01.987.
[47]
Hall M, Wrigley TV, Metcalf BR, et al. A longitudinal study of impact and early stance loads during gait following arthroscopic partial meniscectomy[J]. J Biomech, 2014, 47(12): 2852-2857.
[48]
Tomescu S, Bakker R, Wasserstein D, et al. Dynamically tensioned ACL functional knee braces reduce ACL and meniscal strain[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2018, 26(2):526-533. doi: 10.1007/s00167-017-4794-1.
[49]
Harato K, Niki Y, Kudo Y, et al. Effect of unstable meniscal injury on three-dimensional knee kinematics during gait in anterior cruciate ligament-deficient patients[J]. Knee, 2015, 22(5): 395-399.
[50]
Zhang Y, Huang WH, Yao ZL, et al. Anterior cruciate ligament injuries alter the kinematics of knees with or without meniscal deficiency[J/OL]. Am J Sports Med, 2016, 44(12):3132-3139. doi: 10.1177/0363546516658026.
[51]
Hall M, Bryant AL, Wrigley TV, et al. Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(5):1501-1509. doi: 10.1007/s00167-015-3908-x.
[52]
Dillon PZ, Updyke WF, Allen WC. Gait analysis with reference to chondromalacia patellae[J]. J Orthop Sports Phys Ther, 1983, 5(3): 127-131. DOI: 10.2519/jospt.1983.5.3.127.
[53]
Pietrosimone B, Lepley AS, Murray AM, et al. Changes in voluntary quadriceps activation predict changes in muscle strength and gait biomechanics following knee joint effusion[J/OL]. Clin Biomech (Bristol, Avon), 2014, 29(8):923-929. doi: 10.1016/j.clinbiomech.2014.06.014.
[54]
Phinyomark A, Osis S, Hettinga BA, et al. Gender differences in gait kinematics in runners with iliotibial band syndrome[J/OL]. Scand J Med Sci Sports, 2015, 25(6):744-753. doi: 10.1111/sms.12394.
[55]
Li JS, Tsai TY, Felson DT, et al. Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait[J/OL]. PLoS One, 2017, 12(3):e0174663. doi: 10.1371/journal.pone.0174663.eCollection2017.
[56]
Baan H, Dubbeldam R, Nene AV, et al. Gait analysis of the lower limb in patients with rheumatoid arthritis: a systematic review[J]. Semin Arthritis Rheum, 2012, 41(6): 768-788
[57]
Backhouse MR, Pickles DA, Mathieson HR, et al. Diurnal variation of gait in patients with rheumatoid arthritis: the DIVIGN study[J/OL]. Clin Biomech (Bristol, Avon), 2014, 29(7): 811-814. doi: 10.1016/j.clinbiomech.2014.05.009.
[58]
Oda R, Fujiwara H, Tokunaga D, et al. How do anti-TNF therapies affect gait function in patients with rheumatoid arthritis?[J/OL]. Int J Rheum Dis. 2014, 17(1):57-62. doi: 10.1111/1756-185X.12128.
[59]
Orita N, Deie M, Shimada N, et al. Posterior tibial displacement in the PCL-deficient knee is reduced compared to the normal knee during gait[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11):3251-3258. doi: 10.1007/s00167-014-3162-7.
[60]
Van Den Boom LG, Halbertsma JP, Van Raaij JJ, et al. No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2014,22(12):3135-3141. doi: 10.1007/s00167-014-3215-y.
[61]
Carnesecchi O, Philippot R, Boyer B, et al. Recovery of gait pattern after medial patellofemoral ligament reconstruction for objective patellar instability[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2016,24(1):123-128. doi: 10.1007/s00167-014-3347-0.
[1] 刘鹏, 罗天, 许珂媛, 邓红美, 李瑄, 唐翠萍. 八段锦对膝关节炎疗效的初步步态分析[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 590-595.
[2] 苏介茂, 齐岩松, 王永祥, 魏宝刚, 马秉贤, 张鹏飞, 魏兴华, 徐永胜. 关节镜手术在早中期膝骨关节炎治疗的应用进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 646-652.
[3] 谢佳乐, 李琦, 芦升升, 姜劲松. 内侧膝骨关节炎伴胫股关节冠状半脱位的手术治疗[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 653-657.
[4] 许银峰, 盛璞义, 余世明, 张阳春. 偏心性髋臼旋转截骨术治疗发育性髋关节发育不良[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 568-574.
[5] 李志文, 李远志, 李华, 方志远. 糖皮质激素治疗膝骨关节炎疗效的网状Meta分析[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 484-496.
[6] 闫泽辉, 狄靖凯, 郭子瑊, 穆昶江, 张智博, 陈帅, 王泽华, 田最, 向川. 膝关节机械感受器在半月板损伤中的功能[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 524-531.
[7] 于威, 王艺凯, 杨文博, 孟春庆, 王洪, 黄玮. 陈旧性前交叉韧带胫骨止点撕脱骨折的诊疗进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 532-537.
[8] 杨滢甄, 黄子荣, 梁家敏, 黄晓芳, 胡艳, 朱伟民. 膝关节前交叉韧带重建术前康复治疗的研究进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 538-544.
[9] 庄若语, 杭明辉, 李文华, 张霆, 侯炜. 膝骨关节炎半定量磁共振评分研究进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 545-552.
[10] 王冰, 孙海宁, 于秀淳, 周珂, 翟凯, 苗族康. 膝骨关节炎的活动衬垫型单髁置换疗效与假体生存率[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 337-345.
[11] 张江礼, 刘金辉, 潘西庆, 刘光源, 范虓. 全膝关节置换应用智能辅助手术导航系统治疗膝骨关节炎[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 346-351.
[12] 王振宇, 张洪美, 荆琳, 何名江, 闫奇. 膝骨关节炎相关炎症因子与血浆代谢物间的因果关系及中介效应[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 467-473.
[13] 高广涵, 张耀南, 石磊, 王林, 王飞, 郑子天, 王鸿禹, 郭民政, 薛庆云. 膝骨关节炎患者前交叉韧带功能影像学影响因素分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 301-307.
[14] 曾倩, 徐朝阳, 张丽芳. 帕金森病步态分析的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(04): 235-238.
[15] 于晓光, 秦永辉, 李佳, 贾国兴, 李军, 赵振栓, 刘国彬. 人工单髁置换术治疗膝关节内侧间室骨关节炎合并前交叉韧带功能不良的近期疗效[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 337-342.
阅读次数
全文


摘要