Gait and postural factors of pain progression and physical function changes in patients with osteoarthritis
10.3760/cma.j.cn115682-20211224-05817
- VernacularTitle:髋关节骨性关节炎患者步态及姿势对疼痛进展和身体功能变化的影响
- Author:
Hongli GUO
1
;
Guili ZHANG
;
Jie WANG
;
Gang WANG
Author Information
1. 郑州大学第一附属医院康复医学科，郑州 450052
- Keywords:
Osteoarthritis, hip;
Pain;
Physical function;
Gait;
Standing posture
- From:
Chinese Journal of Modern Nursing
2022;28(31):4309-4316
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate changes of hip pain and physical function in patients with osteoarthritis (OA) and analyze the gait and postural factors related to pain progression and functional changes.Methods:From March 2019 to May 2021, a total of 300 patients with OA admitted to the First Affiliated Hospital of Zhengzhou University were consecutively enrolled. The visual analog scale (VAS) and the physical function subscale of the 36-item short form health survey (SF-36) were used to assess hip pain and physical function at enrollment (baseline) and after 12 months of follow-up, respectively. The Vicon 3D motion capture system was used to assess the gait of the patients, and the spinal line angle and mobility in the sagittal plane were measured using a spinal mouse. Linear regression analysis was performed with hip pain and changes in physical function as dependent variables and factors related to gait and standing posture as independent variables. Age, joint space width (JSW) , hip pain and physical function at baseline were adjusted.Results:Linear regression analysis showed that limited hip extension angle [standardized regression coefficient ( β) was -0.52, 95% confidence interval ( CI) : -0.88 to -0.17]and limited hip rotation ( β=-0.51, 95% CI: -0.85 to -0.18) were the influencing factors of hip pain ( P<0.05) . Increased thoracic kyphosis ( β=-0.54, 95% CI: -0.99 to -0.09) , decreased anterior sacral slope ( β=0.40, 95% CI: 0.01 to 0.79) , decreased thoracic range of motion ( β=0.59, 95% CI: 0.23 to 0.94) , decreased daily walking steps ( β=0.53, 95% CI: 0.13 to 0.92 ) and decreased walking speed ( β=0.45, 95% CI: 0.04 to 0.86 ) were the influencing factors of decreased physical function ( P<0.05) . Conclusions:Limited hip extension and external rotation during walking are related factors of hip pain aggravation in patients with OA. Increased thoracic kyphosis, decreased anterior sacral slope, decreased thoracic range of motion, decreased daily walking steps and decreased walking speed are the influencing factors of decreased physical function. It is suggested that nurses should take the above factors as the focus of clinical intervention to prevent the progression of OA.
