文章基本信息

标题：GAIT ANALYSIS OF PATIENTS WITH OSTEOARTHRITIS OF THE HIP JOINT
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作者：Árpád Illyés, Rita M. Kiss
期刊名称：Facta Universitatis : Series Physical Education and Sport
印刷版ISSN：1451-740X
出版年度：2005
卷号：3
期号：01
页码：1-9
出版社：University of Niš
摘要：Patients with osteoarthritis of the hip joint suffer from pain and functional impairment of the hip over a long period of time. Although different functional scores are widely used to assess improvement after surgery, the patients' responses are often subjective and the disparities between the patients' and doctors' evaluations can be significant. Therefore, objective and quantified data from gait analysis could be useful. Patients may adapt their gait in response to pain, deformity or laxity in the joints of the lower extremities. It is difficult to identify objective parameters for assessing joint function when evaluating the outcome of orthopaedic procedures, especially endoprosthetic hip replacement. A clinical gait analysis enables movement parameters to be quantified. Spatial and temporal gait parameters have clinical relevance in the assessment of motor pathologies, particularly in orthopaedics. The aim of this study is to determine how selected gait parameters may change as a result of coxarthritis. A total of 11 patients with severe unilateral osteoarthritis of the hip and 21 healthy elderly subjects without any history of lower extremity joint pathology were examined at self-selected speeds. Gait analysis was performed using an ultrasound-based Zebris system with a 19-point biomechanical model. From the spatial coordinates of the investigated antropometrical points, the kinematical data (step length, step width, knee, hip and pelvic angles) was calculated. The difference in step width and step length between the two sides is not significant. Significant statistical differences in joint angles were observed between the non-affected and affected limbs. In this research, spatial gait parameters did not show significant asymmetry, although all the patients had unilateral hip diseases. This may occur when the patient walks with short steps or when compensatory movements of other joints are involved. Asymmetry was observed in the range of hip motion as well as knee motion. The maximum hip flexion and extension on the affected side were inversely correlated with the maximum hip extension and flexion on the non-affected side. Therefore, it was suggested that the increased motion of the opposite hip was a compensatory function. The study showed that the increased pelvic obliquity directly correlated with the range of hip flexion. When the range of hip motion is decreased, it might be expected that increased pelvic obliquity would occur as a compensation. The present study detected an influence of the decreased range of affected hip motion on the ipsilateral knee as a decreased range of knee joint motion.
The results indicate a generally poor functional outcome, even though asymmetrical loading was observed. Major limitations in physical function were detected.
关键词：gait analysis, 3D kinematics, kinetics, hip osteoarthritis.