Knee joint kinematic characteristics of general joint hypermobility patients during walking

doi:10.3877/cma.j.issn.1674-134X.2020.01.006

Abstract

Abstract:

Objective

To study the knee joint kinematic characteristics of general joint hypermobility (GJH) patients during level and downhill walking.

Methods

18-24-year-old healthy college volunteers were recruited(Exclude the history of knee joint injury, etc) and divided into two groups: general joint hypermobility group (GJH group)(Beighton score ≥ 5, n=21) and normal group (n=49). The demographic information and questionnaires like IKDC 2000, Lysholm score of all subjects were investigated. The Beighton scoring system were assessed by the experienced operator. The gait analysis system was used to collect the data of the knee joint kinematic parameters. Independent sample t test and chi-square test were used for statistical analysis.

Results

There was no significant difference in flexion and extension angles between the GJH group and the normal group during level walking. However, compared to the normal group the GJH group showed a greater flexion angle in the swing phase than the normal group when walking downhill (maximum flexion angle): (67.40±5.48)°vs (62.27±6.57)°(t=-2.961, P<0.01). The GJH group showed a greater external angle and anterior translation during level walking (anterior/posterior translation in the middle stance phase, 12% gait) and downhill walking: (0.73±0.45)mm vs (0.23±0.27)mm(t =-4.713, P<0.001). The greater external angle and anterior translation (anterior/posterior translation in the middle stance phase, 12% gait): (0.78±0.62)mm vs (0.20±0.36)mm(Z =-3.873, P<0.001)increased more obviously when walking downhill.

Conclusions

The GJH patients present greater changes in gait parameters when walking downhill, which may be compensated by the muscles around the knee joint. As for the abnormal gait parameters, it is possible to enhance the muscle strength around the knee joint of the GJH patients through gait retraining and joint stability training, so as to enhance the stability of the knee joint.

Key words: Joint laxity, Knee joint, Biomechanical phenomena, Walking

Guoqing Zhong, Xiaolong Zeng, Yu Xie, Junya Lai, Chunsheng Liu, Zehao Zheng, Shouxuan Chen, Jie Huang, Lexi Huang, Zhuocheng Xu, Junhan Wu, Wenhan Huang, Limin Ma, Ming Wang, Liping Li, Yu Zhang. Knee joint kinematic characteristics of general joint hypermobility patients during walking[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(01): 33-39.

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Figures/Tables 8

References 34

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组别	例数	年龄[岁，(±s)]	BMI [kg/m², (±s)]	身高[cm，(±s)]	体重[kg，(±s)]
GJH组	21	20.2±1.6	20.9±3.0	162.8±6.2	55.3±9.9
正常组	49	20.2±1.4	20.9±2.7	169.1±8.6	60.3±8.7
统计值	－	t＝－0.016	t＝0.083	t＝3.417	t＝1.991
P值	－	>0.05	>0.05	<0.01	<0.05
组别	例数	性别(男/女)	运动后关节不适史[例，(是/否)]	IKDC量表[分，(±s)]	Lysholm评分[分，(±s)]
GJH组	21	2/19	5/16	80.0±13.0	95.0±7.1
正常组	49	38/11	9/40	77.0±12.0	95.6±6.3
统计值	－	χ²＝27.778	χ²＝0.038	t＝－0.441	t＝0.288
P值	－	<0.05	>0.05	>0.05	>0.05

组别	例数	年龄[岁，(±s)]	BMI [kg/m², (±s)]	身高[cm，(±s)]	体重[kg，(±s)]
GJH组	21	20.2±1.6	20.9±3.0	162.8±6.2	55.3±9.9
正常组	49	20.2±1.4	20.9±2.7	169.1±8.6	60.3±8.7
统计值	－	t＝－0.016	t＝0.083	t＝3.417	t＝1.991
P值	－	>0.05	>0.05	<0.01	<0.05
组别	例数	性别(男/女)	运动后关节不适史[例，(是/否)]	IKDC量表[分，(±s)]	Lysholm评分[分，(±s)]
GJH组	21	2/19	5/16	80.0±13.0	95.0±7.1
正常组	49	38/11	9/40	77.0±12.0	95.6±6.3
统计值	－	χ²＝27.778	χ²＝0.038	t＝－0.441	t＝0.288
P值	－	<0.05	>0.05	>0.05	>0.05

组别	例数	最大屈曲角度(73%) (°)	支撑相中期(31%)内外旋角度(°)	支撑相末期(50%)内收外展角度(°)	支撑相中期(12%)前后位移(mm)	摆动相早期(62%)内外侧位移(mm)	屈伸活动范围(°)	前后位移活动范围(mm)
GJH组	21	59.32±4.42	2.06±2.90	－0.70±1.16	0.73±0.45	0.49±0.25	60.41±5.33	1.66±0.68
正常组	49	56.61±5.90	－0.48±2.69	－1.33±1.24	0.23±0.27	0.20±0.28	56.84±4.95	1.33±0.38
统计值	－	t＝－1.864	t＝－3.482	t＝－1.956	t＝－4.713	t＝－3.990	t＝－2.662	Z＝－1.480
P值	－	>0.05	<0.05	>0.05	<0.01	<0.01	<0.05	>0.05

组别	例数	最大屈曲角度(73%) (°)	支撑相中期(31%)内外旋角度(°)	支撑相末期(50%)内收外展角度(°)	支撑相中期(12%)前后位移(mm)	摆动相早期(62%)内外侧位移(mm)	屈伸活动范围(°)	前后位移活动范围(mm)
GJH组	21	59.32±4.42	2.06±2.90	－0.70±1.16	0.73±0.45	0.49±0.25	60.41±5.33	1.66±0.68
正常组	49	56.61±5.90	－0.48±2.69	－1.33±1.24	0.23±0.27	0.20±0.28	56.84±4.95	1.33±0.38
统计值	－	t＝－1.864	t＝－3.482	t＝－1.956	t＝－4.713	t＝－3.990	t＝－2.662	Z＝－1.480
P值	－	>0.05	<0.05	>0.05	<0.01	<0.01	<0.05	>0.05

组别	例数	最大屈曲角度(73%) (°)	支撑相中期(31%)内外旋角度(°)	支撑相末期(50%)内收外展角度(°)	支撑相中期(12%)前后位移(mm)	摆动相早期(62%)内外侧位移(mm)	屈伸活动范围(°)	前后位移活动范围(mm)
GJH组	21	67.40±5.48	4. 00±7.90	－2.26±2.06	0.78±0.62	0.60±0.51	0.67±0.28	1.17±0.41
正常组	49	62.27±6.57	－0.90±3.36	－2.50±2.09	0.20±0.36	0.11±0.27	0.62±0.21	1.07±0.50
统计值	－	t＝－2.961	Z＝－2.868	t＝－0.414	Z＝－3.873	Z＝－4.440	Z＝－0.163	Z＝－1.381
P值	－	<0.05	<0.05	>0.05	<0.01	<0.01	>0.05	>0.05

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