BACKGROUND A larger daily cumulative hip loading, which is the product of the external hip adduction moment (HAM) impulse during gait and the number of steps per day has been identified as a factor associated with the progression of secondary hip osteoarthritis (OA). The cause of the increased HAM impulse in patients with hip OA has not been identified. The purpose of this study was to identify the gait parameters associated with HAM impulse during gait in patients with secondary hip OA. METHODS Fifty-five patients (age 22-65 years) with mild-to-moderate secondary hip OA participated in this cross-sectional study. The HAM impulse during gait was measured using a three-dimensional gait analysis system. To identify the gait parameters associated with HAM impulse, hierarchical multiple regression analysis was performed. The first model (basic model) included body weight and stance phase duration. The second models included gait parameters (gait speed; ground reaction force [GRF] in frontal plane; and hip, pelvic, and trunk angle in frontal plane) and hip pain in addition to the basic model. RESULTS Body weight and stance phase duration explained 61% of the variance in HAM impulse. In the second model, which took into account body weight and stance phase duration, hip adduction angle (9.4%), pelvic tilt (6.5%), and trunk lean (3.2%) in addition to GRF explained the variance in the HAM impulse. Whereas larger hip adduction angle and pelvic tilt toward the swing limb were associated with a larger HAM impulse, larger trunk lean toward the stance limb was associated with smaller HAM impulse. CONCLUSION In patients with excessive hip adduction and pelvic tilt toward the swing limb during gait, gait modification may contribute to the reduction of hip joint loading.

中文翻译：

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继发性髋骨关节炎患者的髋部，骨盆和躯干的步态运动学与外部髋关节内收力矩有关：确定步态改变关键点。

背景技术较大的每日累积髋关节负荷是步态期间外部髋关节内收力矩（HAM）冲动和每天步数的乘积，已被确定为与继发性髋骨关节炎（OA）进展相关的因素。尚未发现髋骨OA患者HAM冲动增加的原因。这项研究的目的是确定继发性髋关节炎OA患者步态中与HAM脉冲相关的步态参数。方法55例轻度至中度继发性髋关节炎OA患者（年龄22-65岁）参加了这项横断面研究。使用三维步态分析系统测量步态中的HAM脉冲。为了确定与HAM脉冲相关的步态参数，进行了层次多元回归分析。第一个模型（基本模型）包括体重和站立阶​​段的持续时间。除了基本模型之外，第二种模型还包括步态参数（步态速度；额叶的地面反作用力[GRF]；额叶的髋部，骨盆和躯干角）和髋部疼痛。结果体重和站立阶​​段的持续时间可以解释HAM脉冲变化的61％。在第二个模型中，除了考虑GRF之外，还考虑了体重和站立阶​​段的持续时间，髋关节内收角（9.4％），骨盆倾斜（6.5％）和躯干倾斜（3.2％），这说明了HAM脉冲的变化。较大的髋关节内收角和向摆动肢体的骨盆倾斜与较大的HAM冲动相关，而向后肢倾斜的较大躯干与较小的HAM冲动相关。