Houck J, Yack H J
Ithaca College, School of Health Science and Human Performance, Department of Physical Therapy, Rochester, NY 14623, USA.
J Orthop Sports Phys Ther. 2001 Sep;31(9):481-9; discusssion 490-5. doi: 10.2519/jospt.2001.31.9.481.
Case study.
To compare knee kinematics and moments of nongiving way trials to a giving way trial during a combined stepping and crossover cutting activity.
The knee kinematics and moments associated with giving way episodes suggest motor control strategies that lead to instability and recovery of stability during movement.
A 27-year-old woman with anterior cruciate ligament deficiency reported giving way while performing a combined stepping and crossover cutting activity. A motion analysis system recorded motion of the pelvis, femur, tibia, and foot using 3 infrared emitting diodes placed on each segment at 60 Hz. Force plate recordings at 300 Hz were combined with limb inertial properties and position data to estimate net knee joint moments. The stance time, foot progression angle, and cutting angle were also included to evaluate performance between trials.
Knee internal rotation during the giving way trial increased 3.2 degrees at 54% of stance relative to the nongiving way trials. Knee flexion during the giving way trial increased to 33.1 degrees at 66% of stance, and the knee moment switched from a nominal flexor moment to a knee extensor moment at 64% of stance. The knee abductor moment and external rotation moment during the giving way trial deviated in early stance.
The observed response to the giving way event suggests that increasing knee flexion may enhance knee stability for this subject. The transverse and frontal plane moments appear important in contributing to the giving way event. Further research that assists clinicians in understanding how interventions can impact control of movements in these planes is necessary.
病例研究。
比较在联合跨步和交叉切入动作中,未出现打软腿试验与出现打软腿试验时的膝关节运动学和力矩。
与打软腿发作相关的膝关节运动学和力矩表明,在运动过程中导致不稳定和恢复稳定的运动控制策略。
一名27岁的前交叉韧带缺失女性在进行联合跨步和交叉切入动作时报告出现打软腿。一个运动分析系统使用放置在每个节段上的3个红外发光二极管,以60赫兹的频率记录骨盆、股骨、胫骨和足部的运动。以300赫兹的频率记录的测力台数据与肢体惯性特性和位置数据相结合,以估计膝关节净力矩。还包括站立时间、足部前进角度和切入角度,以评估各试验之间的表现。
与未出现打软腿试验相比,出现打软腿试验时膝关节内旋在站立54%时增加了3.2度。出现打软腿试验时膝关节屈曲在站立66%时增加到33.1度,并且膝关节力矩在站立64%时从名义上的屈肌力矩转变为伸肌力矩。出现打软腿试验时膝关节外展力矩和外旋力矩在站立初期出现偏差。
观察到的对打软腿事件的反应表明,增加膝关节屈曲可能会增强该受试者的膝关节稳定性。横断面和额状面力矩在导致打软腿事件中似乎很重要。有必要进行进一步的研究,以帮助临床医生了解干预措施如何影响这些平面内的运动控制。