步态分析在膝骨关节炎疗效评价中的应用

目的：探讨步态分析在膝骨关节炎疗效评价中的应用。方法：对52例膝骨关节炎患者行电针治疗，隔日1次，连续治疗10次为1疗程，半年后随访。采用日本骨科协会（JOA）的膝关节评分法在治疗前后及随访时进行疗效评定，同时观察并分析步态参数，包括支撑期时间、支撑期各阶段时间百分比等变化。结果：电针治疗后JOA各项指标及总分均有改善（P〈0．001），总有效率为92．3％．治疗后左右两侧支撑期时间均小于疗前，分别为P=0．005，P=0．014，差异具有统计学意义。支撑期各阶段时间百分比比较，治疗前与治疗后，与正常参考值比较，前足着地阶段时间延长，全足支撑阶段和前足蹬离阶段时间缩短，左右两侧四个阶段比较差异均无统计学意义（P〉0．05）。治疗后与治疗前同侧同阶段比较，时间百分比无明显改变，差异无统计学意义（P〉0．05）。结论：步态分析可以作为临床疗效评估的客观依据，两者结合能更加客观科学地阐述膝骨关节炎的临床结局。

Application of Gait Analysis in the Curative Effect Evaluation of Knee Osteoarthritis

Objective：To explore the application of gait analysis in the curative effect evaluation of knee osteoarthritis. Meth- ods：Fifty-two patients with early knee osteoarthritis were treated by electro-acupuncture. Efficacy was assessed by Japa- nese Orthopaedic Association （JOA） Knee Score before and after treatment and during follow-up. Gait parameters were ob- served and analyzed. Results： The JOA scores were improved after electro-acupuncture （P〈0. 001）. The total effective rate was 92.3%. After the treatment, stance phases of the left and right sides were less than before treatment, respectively. The difference was significant （P〈0. 05）. Forefoot contact phase was increased in the percentage of various stages of stance phase compared between before and after treatment and also compared with the normal reference values. Foot flat phase and forefoot push off phase shortened. The difference was insignificant comparing left and right sides of the four sta- ges （P〉0.05）. After treatment, no significant change was found in the percentage of time before treatment with ipsilateral stage （P〉 0.05）. Conclusion： Gait analysis can be used as an objective basis for assessing the clinical efficacy. Combination can be more objective and scientific exposition of the clinical outcome of knee osteoarthritis.