PDF(Pubmed)
Abstract：
OBJECTIVE: Knee kinematic asymmetries after anterior cruciate ligament reconstruction (ACLR) are correlated with poor clinical outcomes, such as the progression of knee cartilage degenerations or reinjuries. Fast walking in patients with knee conditions may exacerbate knee kinematic asymmetries, but its impact on ACLR patients is uncertain. The aim of this study is to investigate if fast walking induces more knee kinematic asymmetries in unilateral ACLR patients.
METHODS: This cross-sectional study enrolled 55 patients with unilateral ACLR from January 2020 to July 2022. There were 48 males and seven females with an average age of 30.6 ± 6.4 years. Knee kinematic data were collected at three walking speeds: self-selected, fast (150% normal), and slow (50% normal). A 3D knee kinematic analysis system measured the data, and self-reported outcomes assessed comfort levels during walking. We used SPM1D for two-way repeated ANOVA and posthoc paired t-tests to analyze kinematic differences in groups.
RESULTS: In fast walking, ACLR knees exhibited more transverse kinematic asymmetries than intact knees, including greater external rotation angle (1.8°, 38%-43%; gait cycle [GC], p < 0.05 & 1.8-2.7°, 50%-61% GC, p < 0.05) and increased proximal tibial translation (2.1-2.5 mm, 2%-6% GC, p < 0.05 & 2.5-3.2 mm, 92%-96% GC, p < 0.05). Additionally, ACLR knees showed greater posterior tibial translation than intact knees (3.6-3.7 mm, 7%-8% GC, p < 0.05) during fast walking. No posterior tibial translation asymmetries were observed in slow walking compared to normal walking levels. ACLR knees have the most comfortable feelings in slow walking speed, and the most uncomfortable feelings in fast walking speed levels (29%).
CONCLUSIONS: Fast walking induces additional external tibial rotation and proximal and posterior tibial translation asymmetries in ACLR patients. This raises concerns about long-term safety and health during fast walking. Fast walking, not self-selected speed, is beneficial for identifying postoperative gait asymmetries in ACLR patients.
METHODS: This cross-sectional study enrolled 55 patients with unilateral ACLR from January 2020 to July 2022. There were 48 males and seven females with an average age of 30.6 ± 6.4 years. Knee kinematic data were collected at three walking speeds: self-selected, fast (150% normal), and slow (50% normal). A 3D knee kinematic analysis system measured the data, and self-reported outcomes assessed comfort levels during walking. We used SPM1D for two-way repeated ANOVA and posthoc paired t-tests to analyze kinematic differences in groups.
RESULTS: In fast walking, ACLR knees exhibited more transverse kinematic asymmetries than intact knees, including greater external rotation angle (1.8°, 38%-43%; gait cycle [GC], p < 0.05 & 1.8-2.7°, 50%-61% GC, p < 0.05) and increased proximal tibial translation (2.1-2.5 mm, 2%-6% GC, p < 0.05 & 2.5-3.2 mm, 92%-96% GC, p < 0.05). Additionally, ACLR knees showed greater posterior tibial translation than intact knees (3.6-3.7 mm, 7%-8% GC, p < 0.05) during fast walking. No posterior tibial translation asymmetries were observed in slow walking compared to normal walking levels. ACLR knees have the most comfortable feelings in slow walking speed, and the most uncomfortable feelings in fast walking speed levels (29%).
CONCLUSIONS: Fast walking induces additional external tibial rotation and proximal and posterior tibial translation asymmetries in ACLR patients. This raises concerns about long-term safety and health during fast walking. Fast walking, not self-selected speed, is beneficial for identifying postoperative gait asymmetries in ACLR patients.
摘要：
目的：前交叉韧带重建术（ACLR）后膝关节运动不对称性与不良临床结局相关，如膝关节软骨退化或再损伤的进展。膝关节疾病患者的快速行走可能会加剧膝关节运动学不对称，但其对ACLR患者的影响尚不确定。这项研究的目的是调查快速行走是否会在单侧ACLR患者中引起更多的膝关节运动学不对称。
方法：这项横断面研究纳入了2020年1月至2022年7月的55例单侧ACLR患者。男性48例，女性7例，平均年龄30.6±6.4岁。以三种步行速度收集膝关节运动学数据：自我选择，快（150%正常），和缓慢（50％正常）。三维膝关节运动学分析系统测量数据，自我报告的结果评估了步行过程中的舒适度。我们使用SPM1D进行双向重复方差分析和posthoc配对t检验来分析组中的运动学差异。
结果：在快速行走中，ACLR膝盖表现出更多的横向运动不对称性比完整的膝盖，包括更大的外部旋转角度(1.8°，38%-43%；步态周期[GC]，p<0.05&1.8-2.7°,50%-61%GC,p<0.05）和增加的近端胫骨平移（2.1-2.5毫米，2%-6%GC，p<0.05&2.5-3.2mm,92%-96%GC，p<0.05)。此外,ACLR膝关节显示胫骨后平移大于完整膝关节（3.6-3.7mm，7%-8%GC，p<0.05)在快速行走期间。与正常行走水平相比，在缓慢行走中未观察到胫骨后平移不对称。ACLR膝盖在缓慢的行走速度下有最舒适的感觉，和最不舒服的感觉在快速步行速度水平（29％）。
结论：在ACLR患者中，快速行走会引起额外的胫骨外旋转以及胫骨近端和后端平移不对称。这引起了人们对快速步行过程中的长期安全和健康的担忧。快速行走，不是自选速度，有助于识别ACLR患者术后步态不对称。
方法：这项横断面研究纳入了2020年1月至2022年7月的55例单侧ACLR患者。男性48例，女性7例，平均年龄30.6±6.4岁。以三种步行速度收集膝关节运动学数据：自我选择，快（150%正常），和缓慢（50％正常）。三维膝关节运动学分析系统测量数据，自我报告的结果评估了步行过程中的舒适度。我们使用SPM1D进行双向重复方差分析和posthoc配对t检验来分析组中的运动学差异。
结果：在快速行走中，ACLR膝盖表现出更多的横向运动不对称性比完整的膝盖，包括更大的外部旋转角度(1.8°，38%-43%；步态周期[GC]，p<0.05&1.8-2.7°,50%-61%GC,p<0.05）和增加的近端胫骨平移（2.1-2.5毫米，2%-6%GC，p<0.05&2.5-3.2mm,92%-96%GC，p<0.05)。此外,ACLR膝关节显示胫骨后平移大于完整膝关节（3.6-3.7mm，7%-8%GC，p<0.05)在快速行走期间。与正常行走水平相比，在缓慢行走中未观察到胫骨后平移不对称。ACLR膝盖在缓慢的行走速度下有最舒适的感觉，和最不舒服的感觉在快速步行速度水平（29％）。
结论：在ACLR患者中，快速行走会引起额外的胫骨外旋转以及胫骨近端和后端平移不对称。这引起了人们对快速步行过程中的长期安全和健康的担忧。快速行走，不是自选速度，有助于识别ACLR患者术后步态不对称。
