周萌;曹光磊;张宽;冯明利;安帅;沈惠良;

• 1:首都医科大学宣武医院
• 2:首都医科大学生物医学工程学院

摘要(Abstract)：

[目的]利用便携式步态分析仪了解患者膝关节置换前后的步态参数变化及特点,指导全膝关节置换术(total knee arthroplasty,TKA)后的康复治疗,进而得出适用于临床的评价方式。[方法]通过便携式步态分析仪对行单侧TKA的患者进行术前及术后3个月的步态分析,评估术后步态参数改善程度。[结果]患者手术侧肢体摆动时间、步幅持续时间、摆腿强度、蹬地强度、跖屈强度、步速、步频、步长、步幅及行走中活动度在行TKA后3个月有明显改善。[结论]1全膝关节置换患者术后3个月疼痛明显减轻,膝关节活动度增加,功能得到良好改善;2对于术后康复锻炼,除常规增加膝关节活动锻炼外,还应加强股四头肌的锻炼,以增强术后膝关节稳定性,改善功能;3便携式步态分析仪(portable motion analyzer,PMA)可以客观地记录全膝关节置换患者术前及术后的步态参数,对评价手术效果及指导功能康复具有一定的参考价值。

关键词(KeyWords)： 步态分析;人工膝关节;置换;便携式步态分析仪

Abstract:

Keywords:

基金项目(Foundation): 首都医科大学基础临床科研合作课题(项目编号:1300171727)

作者(Author): 周萌;曹光磊;张宽;冯明利;安帅;沈惠良;

Email:

DOI:

参考文献(References)：

• [1]Clement ND,Burnett R.Patient satisfaction after total knee arthroplasty is affected by their general physical well-being[J].Knee Surg Sports Traumatol Arthrosc,2013,11:2638-2646.
• [2]Baker PN,Rushton S,Jameson SS,et al.Patient satisfaction with total knee replacement cannot be predicted from pre-operative variables alone:a cohort study from the national joint registry for england and wales[J].Bone Joint J,2013,10:1359-1365.
• [3]Robinson JL,Smidt GL.Quantitative gait evaluation in the clinic[J].Physical Ther,1981,3:351-353.
• [4]Jiang Y,Larson JL.Ideea activity monitor:validity of activity recognition for lying,reclining,sitting and standing[J].Front Med,2013,1:126-131.
• [5]Whybrow S,Ritz P,Horgan GW,et al.An evaluation of the ideea activity monitor for estimating energy expenditure[J].Br J Nutr,2013,1:173-183.
• [6]Mackey AH,Stott NS,Walt SE.Reliability and validity of an activity monitor(ideea)in the determination of temporal-spatial gait parameters in individuals with cerebral palsy[J].Gait Posture,2008,4:634-639.
• [7]Maffiuletti NA,Gorelick M,Kramers-de QI,et al.Concurrent validity and intrasession reliability of the ideea accelerometry system for the quantification of spatiotemporal gait parameters[J].Gait Posture,2008,1:160-163.
• [8]Gorelick ML,Bizzini M,Maffiuletti NA,et al.Test-retest reliability of the ideea system in the quantification of step parameters during walking and stair climbing[J].Clin Physiol Funct Imaging,2009,4:271-276.
• [9]刘艳成,夏群,胡永成,等.便携步态分析量化评价脊髓型颈椎病患者的步态特征[J].中国组织工程研究,2014,11:1774-1779.
• [10]Huddleston J,Alaiti A,Goldvasser D,et al.Ambulatory measurement of knee motion and physical activity:preliminary evaluation of a smart activity monitor[J].J Neuroeng Rehabil,2006,1:21.
• [11]Kalyani RR,Tra Y,Yeh HC,et al.Quadriceps strength,quadriceps power,and gait speed in older U.S.adults with diabetes mellitus:results from the national health and nutrition examination survey,1999-2002[J].J Am Geriatr Soc,2013,5:769-775.
• [12]Mundermann A,Dyrby CO,Andriacchi TP.Secondary gait changes in patients with medial compartment knee osteoarthritis:increased load at the ankle,knee,and hip during walking[J].Arthritis Rheum,2005,9:2835-2844.
• [13]Chiang H,Lee CC,Lin WP,et al.Comparison of quadriceps-sparing minimally invasive and medial parapatellar total knee arthroplasty:a2-year follow-up study[J].J Formosan Med Association,2012,12:698-704.
• [14]Lester DK,Shantharam R,Zhang K.Dynamic electromyography after cruciate-retaining total knee arthroplasty revealed a threefold quadriceps demand compared with the contralateral normal knee[J].J Arthroplasty,2013,4:557-562.
• [15]Li K,Ackland DC,Mc Clelland JA,et al.Trunk muscle action compensates for reduced quadriceps force during walking after total knee arthroplasty[J].Gait Posture,2013,1:79-85.
• [16]Tungtrongjit Y,Weingkum P,Saunkool P.The effect of preoperative quadriceps exercise on functional outcome after total knee arthroplasty[J].J Med Assoc Thai,2012:58-66.