疼痛和性别对步行时冲击负荷的影响:一项随机试验。
Influence of pain and gender on impact loading during walking: a randomised trial.
作者信息
Henriksen Marius, Christensen Robin, Alkjaer Tine, Lund Hans, Simonsen Erik B, Bliddal Henning
机构信息
The Parker Institute: Clinical Motor Function Laboratory, Frederiksberg Hospital, Ndr. Fasanvej 57, DK-2000 Frederiksberg, Denmark.
出版信息
Clin Biomech (Bristol). 2008 Feb;23(2):221-30. doi: 10.1016/j.clinbiomech.2007.09.010. Epub 2007 Nov 5.
BACKGROUND
Knee joint osteoarthritis is painful and with an overweight of female incidence. The cardinal symptom is pain, which causes compensatory gait changes, and gender differences in pain sensitivity exist. Impact loadings at heel strike during walking are suspected as a co-factor in development of knee osteoarthritis. Thus the purpose of this study was to investigate the influence of experimental muscle pain and gender on generation and attenuation of impact loading during walking.
METHODS
Ten healthy males and 10 healthy females were recruited. Impact loadings during walking were measured using force platforms and accelerometers attached to the tibia and sacrum. Impact ground reaction force peaks and loading rates, and peak accelerations were used to quantify impact loadings. Attenuation was quantified by means of a transfer function between the tibial and sacral accelerometer signals, and the relative peak acceleration reduction. Knee joint kinematics were collected using a three-dimensional movement analysis system. The study was a cross-over study and data were collected before, during, and after experimental vastus medialis pain and a control situation.
FINDINGS
Experimental muscle pain did not affect generation or attenuation of impact loading in either gender. While the impact loading magnitude was similar across genders, lower loading rates and more efficient attenuation were observed in females.
INTERPRETATION
It is concluded that generation and attenuation of impact loadings during walking are independent of quadriceps pain in both genders. The present study does not provide any evidence of the tested variables to address the gender differences in loading rates and attenuation.
背景
膝关节骨关节炎疼痛,且女性发病率较高。主要症状为疼痛,这会导致代偿性步态改变,并且存在疼痛敏感性的性别差异。步行时足跟触地时的冲击负荷被怀疑是膝关节骨关节炎发展的一个辅助因素。因此,本研究的目的是探讨实验性肌肉疼痛和性别对步行过程中冲击负荷的产生和衰减的影响。
方法
招募了10名健康男性和10名健康女性。使用力平台以及附着在胫骨和骶骨上的加速度计测量步行过程中的冲击负荷。冲击地面反作用力峰值、负荷率和峰值加速度用于量化冲击负荷。衰减通过胫骨和骶骨加速度计信号之间的传递函数以及相对峰值加速度降低来量化。使用三维运动分析系统收集膝关节运动学数据。该研究为交叉研究,在实验性股内侧肌疼痛期间及之前、之后以及对照情况下收集数据。
结果
实验性肌肉疼痛对男女两性冲击负荷的产生或衰减均无影响。虽然冲击负荷大小在两性之间相似,但女性的负荷率较低且衰减更有效。
解读
得出的结论是,步行过程中冲击负荷的产生和衰减在两性中均与股四头肌疼痛无关。本研究没有提供任何证据表明所测试的变量可解释负荷率和衰减方面的性别差异。