Franco J C, Perell K L, Gregor R J, Scremin A M
Department of Orthopedics, University of New Mexico, Albuquerque, USA.
J Rehabil Res Dev. 1999 Jul;36(3):207-16.
The purpose of this preliminary study was to describe pedal effectiveness parameters and knee-joint reaction forces generated by subjects with chronic spinal cord injury (SCI) during functional electrical stimulation (FES)-induced bicycling. Three male subjects (age 33-36 years old), who were post-traumatic SCI (ASIA-modified level A, level T4-C5) and enrolled in an FES rehabilitation program, signed informed consent forms and participated in this study. Kinematic data and pedal forces during bicycling were collected and effective force, knee-joint reaction forces, knee generalized muscle moments, and knee-joint power and work were calculated. There were three critical findings of this study: 1) pedaling effectiveness was severely compromised in this subject population as indicated by a lack of overall positive crank work; 2) knee-joint kinetics were similar in magnitude to data reported for unimpaired individuals pedaling at higher rates and workloads, suggesting excessive knee-joint loading for subjects with SCI; and 3) shear reaction forces and muscle moments were opposite in direction to data reported for unimpaired individuals, revealing an energetically unfavorable knee stabilizing mechanism. The critical findings of this study suggest that knee-joint kinetics may be large enough to produce a fracture in the compromised lower limbs of individuals with SCI.
这项初步研究的目的是描述慢性脊髓损伤（SCI）患者在功能性电刺激（FES）诱发的骑行过程中产生的踏板效能参数和膝关节反应力。三名男性受试者（年龄33 - 36岁），均为创伤后脊髓损伤（ASIA改良分级为A级，损伤平面T4 - C5），并参加了FES康复项目，他们签署了知情同意书并参与了本研究。收集了骑行过程中的运动学数据和踏板力，并计算了有效力、膝关节反应力、膝关节广义肌肉力矩以及膝关节功率和功。本研究有三个关键发现：1）由于缺乏总体正向曲柄功，表明该受试者群体的蹬踏效能严重受损；2）膝关节动力学在大小上与未受损个体以更高速率和工作量蹬踏时报告的数据相似，这表明脊髓损伤患者的膝关节负荷过大；3）剪切反应力和肌肉力矩的方向与未受损个体报告的数据相反，揭示了一种能量上不利的膝关节稳定机制。本研究的关键发现表明，膝关节动力学可能大到足以在脊髓损伤患者受损的下肢产生骨折。
