摘要
[目的]利用便携式动态步态分析系统测量全膝关节表面置换术(total knee arthroplasty,TKA)手术前后患肢步态参数,评估其步态变化的特点,从而指导术后康复治疗,得到适用于临床的评估方法。[方法]分别在术前及术后3个月应用便携式动态步态分析系统进行步态分析,评估手术前后各步态参数的改善程度。[结果]与术前相比,患肢术后3个月步幅[(81.9±2.6)cm,(110.6±7.4)cm,P<0.001]、步高[(10.5±2.2)cm,(20.6±1.5)cm,P<0.001]、单侧总支撑时长[(49.1±3.1)%,(63.8±1.1)%,P<0.001]、单侧摆动时长[(50.9±3.1)%,(36.2±1.3)%,P<0.001]、单足支撑时长[(30.1±0.5)%,(35.3±0.7)%,P<0.001]、着地仰角[(11.7±1.6)°,(19.5±1.4)°,P<0.001]、离地仰角[(47.4±1.6)°,(60.7±2.8)°,P<0.001]和最大摆动速度[(2.7±0.2)m/s,(3.9±0.3)m/s,P<0.001]均有明显改善。但是术后3个月患者组的着地仰角[(19.5±1.4)°vs(20.5±1.5)°,P=0.012]和最大摆动速度[(3.9±0.3)m/s vs(4.1±0.2)m/s,P=0.006]仍不及健康人组。[结论]全膝关节术后3个月步态有较好改善。便携式动态步态分析系统可以量化评估全膝关节表面置换术前后患者的步态特点,对膝关节置换术后康复锻炼可能有针对性指导价值。
[Objective]To measure the gait parameters of the affected limb before and after total knee arthroplasty(TKA)using a portable dynamic gait analysis system,evaluate the characteristics of gait changes,thereby guiding postoperative rehabilitation and obtaining an applicable assessment method in clinical practice.[Methods]Gait analysis was conducted with the portable dynamic gait analysis system before and 3 months after the TKA,respectively,to evaluate the improvement degree of each gait parameter before and after the operation.[Results]Compared with those before operation,the patients got significant improvements 3 months postoperatively in terms of the stride length[(81.9±2.6)cm,(110.6±7.4)cm,P<0.001],stride height[(10.5±2.2)cm,(20.6±1.5)cm,P<0.001],unilateral total support time[(49.1±3.1)%,(63.8±1.1)%,P<0.001],unilateral swing time[(50.9±3.1)%,(36.2±1.3)%,P<0.001],single foot support time[(30.1±0.5)%,(35.3±0.7)%,P<0.001],landing elevation[(11.7±1.6)°,(19.5±1.4)°,P<0.001],liftoff elevation[(47.4±1.6)°,(60.7±2.8)°,P<0.001]and maximum swing speed[(2.7±0.2)m/s,(3.9±0.3)m/s,P<0.001]of the affected lower extremity.However,the patients remained inferior to the normal persons 3 months after TKA in terms of landing elevation[(19.5±1.4)°vs(20.5±1.5)°,P=0.012]and maximum swing speed[(3.9±0.3)m/s vs(4.1±0.2)m/s,P=0.006].[Conclusion]The patients have significant gait improvements 3 months after TKA.The portable dynamic gait analysis system can quantitatively evaluate the gait characteristics of patients before and after TKA,and might have targeted guiding value for rehabilitation exercises.
作者
聂琛
王敏
邵岩
王成龙
朱庄臣
张国玲
NIE Chen;WANG Min;SHAO Yan;WANG Cheng-long;ZHU Zhuang-chen;ZHANG Guo-ling(Department of Orthopedics,The Second Affiliated Hospital,Shandong FirstMedical University,Tai'an 271000,Shandong,China;Department of Science and Education,The First People's Hospital of Tai'an City,Tai'an 271000,Shandong,China)
出处
《中国矫形外科杂志》
北大核心
2025年第21期2010-2013,共4页
Orthopedic Journal of China
基金
泰安市科技创新发展项目(编号:2020NS243)。
