Théoret Daniel, Lamontagne Mario
School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
Knee Surg Sports Traumatol Arthrosc. 2006 Jun;14(6):555-63. doi: 10.1007/s00167-006-0072-3. Epub 2006 Apr 6.
This investigation examined the muscular activity and 3D knee joint kinematic changes of anterior cruciate ligament-deficient (ACLD) participants in the involved leg under bracing condition during running. Different adaptation strategies have been found between patients who can cope with the injury and patients who cannot. One of the expected changes can be the muscle activation characteristic of the injured knee during strenuous activity with and without a functional knee brace. Three-dimensional kinematic and electromyographical (EMG) data were collected from 11 participants for 10 consecutive gait cycles during running on a treadmill under both braced and unbraced conditions. Participants were administered the "Knee Outcome Survey Activities of Daily Living Scale" to distinguish functional and non-functional candidates. No significant differences on 3D kinematics and EMG data were noted between functional and non-functional participants, thus data analysis focused on comparisons of bracing conditions for one combined group. Bracing significantly reduced total range of motion in the frontal and transverse planes (P<0.05). Muscle activity at heel-strike showed a consistent trend to increase for the hamstrings and decrease for the quadriceps under the braced condition when compared to the unbraced condition. Our findings indicate that bracing the ACLD knee alters the kinematics of the injured leg while running. Tendencies toward reductions in quadriceps and increases in hamstrings activity at heel-strike indicate that bracing might have resulted in added stability of the injured knee. The adaptations to bracing found in this preliminary study further support the potential mechanical and proprioceptive contributions of the functional knee brace to protect the ACLD knee.
本研究调查了前交叉韧带损伤(ACLD)参与者在跑步时佩戴支具情况下患侧下肢的肌肉活动及三维膝关节运动学变化。研究发现,能够应对损伤的患者与不能应对损伤的患者之间存在不同的适应策略。预期变化之一可能是在剧烈活动时,无论有无功能性膝关节支具,受伤膝关节的肌肉激活特征。在跑步机上跑步时,对11名参与者在佩戴和不佩戴支具的情况下连续10个步态周期收集三维运动学和肌电图(EMG)数据。参与者接受了“膝关节功能日常生活量表”评估,以区分功能良好和功能不佳的参与者。功能良好和功能不佳的参与者在三维运动学和EMG数据上无显著差异,因此数据分析集中于对一个合并组的支具条件进行比较。支具显著降低了额面和横面的总运动范围(P<0.05)。与不佩戴支具相比,佩戴支具时足跟触地时的肌肉活动显示,腘绳肌活动呈一致的增加趋势,股四头肌活动呈减少趋势。我们的研究结果表明,对ACLD膝关节佩戴支具会改变跑步时患侧下肢的运动学。足跟触地时股四头肌活动减少和腘绳肌活动增加的趋势表明,佩戴支具可能增加了受伤膝关节的稳定性。在这项初步研究中发现的对支具的适应性变化进一步支持了功能性膝关节支具在保护ACLD膝关节方面的潜在机械和本体感觉作用。