Trunk, pelvis and lower limb walking biomechanics are similarly altered in those with femoroacetabular impingement syndrome regardless of cam morphology size.

Autor: Savage TN; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Kolling Institute of Medical Research, Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: trevor.savage@griffithuni.edu.au., Saxby DJ; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia., Pizzolato C; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia., Diamond LE; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, the University of Queensland, Brisbane, Queensland, Australia., Murphy NJ; Kolling Institute of Medical Research, Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia; Department of Orthopaedic Surgery, Gosford and Wyong Hospitals, New South Wales, Australia., Hall M; Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Spiers L; Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Eyles J; Kolling Institute of Medical Research, Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia., Killen BA; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia., Suwarganda EK; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia., Dickenson EJ; University of Warwick, Coventry, United Kingdom; University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom., Griffin D; University of Warwick, Coventry, United Kingdom; University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom., Fary C; Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia., O'Donnell J; Hip Arthroscopy Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia., Molnar R; Department of Orthopaedic Surgery, St George Hospital, Sydney, New South Wales, Australia; Sydney Orthopaedic and Reconstructive Surgery, Sydney, New South Wales, Australia., Randhawa S; Macquarie University Hospital, Macquarie University, Sydney, NSW, Australia., Reichenbach S; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland., Tran P; Department of Surgery, The University of Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Melbourne, Victoria, Australia., Wrigley TV; Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Bennell KL; Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia., Hunter DJ; Kolling Institute of Medical Research, Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia., Lloyd DG; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2021 Jan; Vol. 83, pp. 26-34. Date of Electronic Publication: 2020 Oct 10.
DOI: 10.1016/j.gaitpost.2020.10.002
Abstrakt: Background: Studies of walking in those with femoroacetabular impingement syndrome have found altered pelvis and hip biomechanics. But a whole body, time-contiuous, assessment of biomechanical parameters has not been reported. Additionally, larger cam morphology has been associated with more pain, faster progression to end-stage osteoarthritis and increased cartilage damage but differences in walking biomechanics between large compared to small cam morphologies have not been assessed.
Research Question: Are trunk, pelvis and lower limb biomechanics different between healthy pain-free controls and individuals with FAI syndrome and are those biomechanics different between those with larger, compared to smaller, cam morphologies?
Methods: Twenty four pain-free controls were compared against 41 participants with FAI syndrome who were stratified into two groups according to their maximum alpha angle. Participants underwent three-dimensional motion capture during walking. Trunk, pelvis, and lower limb biomechanics were compared between groups using statistical parametric mapping corrected for walking speed and pain.
Results: Compared to pain-free controls, participants with FAI syndrome walked with more trunk anterior tilt (mean difference 7.6°, p < 0.001) as well as less pelvic rise (3°, p < 0.001), hip abduction (-4.6°, p < 0.05) and external rotation (-6.5°, p < 0.05). They also had lower hip flexion (-0.06Nm⋅kg -1 , p < 0.05), abduction (-0.07Nm⋅kg -1 , p < 0.05) and ankle plantarflexion moments (-0.19Nm⋅kg -1 , p < 0.001). These biomechanical differences occurred throughout the gait cycle. There were no differences in walking biomechanics according to cam morphology size.
Significance: Results do not support the hypothesis that larger cam morphology is associated with larger differences in walking biomechanics but did demonstrate general differences in trunk, pelvis and lower limb biomechanics between those with FAI sydrome and pain-free controls. Altered external biomechanics are likely the result of complex sensory-motor strategy resulting from pain inhibition or impingement avoidance. Future studies should examine internal loading in those with FAI sydnrome.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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