Research On Different Traditional Chinese Medical Syndromes Of Knee Osteoarthritis Based On Gait Analysis

Objective: By studying the dynamic and static gait parameters of patients with knee osteoarthritis of different TCM(traditional Chinese medical)syndromes,the different rules and characteristics were explored.Methods:(1)From December 2018 to December 2019,60 patients(experimental group)with knee osteoarthritis were selected from the Third Affiliated Hospital of Yunnan University of traditional Chinese medicine,with an average age of(69.78 ±7.71)years;meanwhile,60 normal adults(control group)with knee osteoarthritis were selected,with an average age of(69.63 ± 8.90)years,Using EPS / R1 system produced by Italian Loran engineering company to detect the gait of standing and walking;(2)according to different TCM syndromes,The deficiency type of liver and kidney(n = 21),Syndrome of asthenia of Qi and blood(n = 11)were classified as deficiency type(n = 32),stagnation type of Qi and blood stasis(n = 16),cold dampness obstruction type(n = 12)as positive type(n = 28).The observation indexes included the basic parameters of gait(arch index,average walking speed),static standing parameters(pelvic tilt ratio,peak foot pressure)and dynamic walking parameters(peak foot pressure,contact area in the middle stage of support).Each parameter data was first tested by S-W,the parameters of the experimental group and the control group were compared,the virtual and empirical parameters were compared,and T test or non parameter test were used for statistical analysis to compare their similarities and differences.Results:(1)Compared with the control group,the left and right dynamic and static gait parameters of the experimental group were asymmetric,there was no significant difference in arch index and the proportion of anterior and posterior inclination of pelvis(P > 0.05).and the average walking speed was significantly slower(P < 0.05).When standing,the pressure of right M5 and MF increased,and pelvis tilted to the right(P < 0.05).During walking,the average walking speed of the experimental group slowed down significantly(P < 0.05),and the contact area and pressure peak of MH,LH,MF and forefoot were changed in varying degrees(P < 0.05).(2)There was no significant difference in arch index,average walking speed and the proportion of left and right pelvis inclinations between the positive type and the deficiency type(P > 0.05).When standing,the pressure distribution of the right and left plantar of the positive type and the deficiency type was asymmetric,but the pressure of the right M5 and MF plantar of the deficiency type was significantly higher(P < 0.05).(3)When walking,the pressure peak and contact area of the positive type were the same,but there was no significant difference between the positive type and the deficiency type(P > 0.05),The peak value of MH and LH plantar pressure decreased significantly(P < 0.05),and the weight of metatarsal area and MF increased relatively;Compared with the empirical type,the pressure peak and contact area of the left and right sides of the deficiency type are different,the peak value of right MF and M5 plantar pressure increased significantly,the contact area of right MF and left MF,T2-5decreased significantly(P < 0.05),the peak value of LH plantar pressure increased slightly compared with MH,and the plantar pressure line shifted outward.Conclusions:(1)There are obvious differences in the parameters of the gait between the knee osteoarthritis(TCM positive type,deficiency type)and the normal adults,and the parameters of the left and right sides are not completely the same.(2)The static gait parameters of the two types of knee osteoarthritis in traditional Chinese medicine showed the right leaning of the center of gravity,and the pressure line of the right plantar moved out,among which the deficiency type was more obvious than the empirical type.(3)There are significant differences in the dynamic gait parameters between the empirical and the deficiency type of knee osteoarthritis,which are manifested in the forward center of gravity of the empirical type and the right lateral center of gravity of the deficiency type.(4)To sum up,the gait parameters of the deficiency and demonstration type in traditional Chinese medicine of knee osteoarthritis have certain regularity,and the gait parameters can be used as a certain reference index to distinguish the deficiency and the demonstration type in traditional Chinese medicine of knee osteoarthritis.