Yoshio Masaharu, Murakami Gen, Sato Toshio, Sato Shuichi, Noriyasu Seiji
Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Minami 1 Nishi 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan.
J Orthop Sci. 2002;7(2):199-207. doi: 10.1007/s007760200034.
This study was carried out to analyze the phasic heterogeneity in the function of the psoas major muscle (PMM) depending on the flexion angle at the hip joint. The study design was a passive kinetic experiment using 25 osteoligamentous specimens with the PMM tendon. We measured the flexion angle of the hip joint where the PMM tendon loses contact with the femoral head and pelvic surface. Ten osteoligamentous specimens were used for additional measurements of the tensile force and pressure exerted on the PMM and/or at the bone-tendon interface when the PMM tendon was gently pulled in line with the PMM origin in the supine position. The tension loading the PMM tendon was measured at seven different angled positions of hip joint flexion (0 degrees, 15 degrees, 30 degrees, 45 degrees, 60 degrees, 75 degrees, and 90 degrees ), using a load cell attached to a traction appliance. The pressure was measured at each of eight sites along the long axis of the PMM, using a pressure sensor. The PMM tendon lost contact with the femoral head at angled positions of 14 degrees (average) hip flexion, and lost contact with the iliopectineal eminence at positions of 54 degrees (average). The tension was stronger at angled positions of 0 degrees -30 degrees at the hip joint. The pressure on the femoral head and pelvic surface were stronger at positions of 0 degrees -30 degrees at the hip joint. The pressure on the femoral head was strongest at a hip flexion of 0 degrees. The tensile force markedly decreased at 45 degrees -60 degrees flexion at the hip joint, while the pressure on the femoral head gradually reduced to zero in the same phases. We concluded that the PMM works phasically: (1) as an erector of the lumbar vertebral column, as well as a stabilizer of the femoral head in the acetabulum at 0 degrees -15 degrees flexion at the hip joint; (2) less as a stabilizer, in contrast to maintaining its erector action, at 15 degrees -45 degrees; and (3) as an effective flexor of the lower extremity, at 45 degrees -60 degrees.
本研究旨在分析腰大肌（PMM）功能的阶段性异质性与髋关节屈曲角度的关系。研究设计为使用25个带有PMM肌腱的骨韧带标本进行被动动力学实验。我们测量了PMM肌腱与股骨头和骨盆表面失去接触时的髋关节屈曲角度。10个骨韧带标本用于在仰卧位时沿PMM起点方向轻轻拉动PMM肌腱时，对PMM和/或骨-肌腱界面施加的拉力和压力的额外测量。使用连接在牵引装置上的测力传感器，在髋关节屈曲的七个不同角度位置（0度、15度、30度、45度、60度、75度和90度）测量加载在PMM肌腱上的张力。使用压力传感器在沿PMM长轴的八个部位测量压力。PMM肌腱在髋关节平均屈曲14度的角度位置与股骨头失去接触，在平均54度的位置与髂耻隆起失去接触。在髋关节0度至30度的角度位置，张力更强。在髋关节0度至30度的位置，对股骨头和骨盆表面的压力更强。在髋关节屈曲0度时，对股骨头的压力最大。在髋关节屈曲45度至60度时，拉力显著下降，而在相同阶段对股骨头的压力逐渐降至零。我们得出结论，PMM的工作具有阶段性：（1）在髋关节屈曲0度至15度时，作为腰椎的伸展肌以及髋臼中股骨头的稳定器；（2）在15度至45度时，与保持伸展作用相比，作为稳定器的作用较小；（3）在45度至60度时，作为下肢的有效屈肌。
