Reid Samantha M, Lynn Scott K, Musselman Reilly P, Costigan Patrick A
School of Kinesiology and Health Studies, Queen's University, Kingston, Canada.
Med Sci Sports Exerc. 2007 Nov;39(11):2005-11. doi: 10.1249/mss.0b013e31814538c8.
This study compared the kinematics and kinetics of the knee joint during traditional step-over-step (SOS) and compensatory step-by-step lead-leg (SBSL) and trail-leg (SBST) stair ambulation patterns.
Seventeen (M:9) healthy adults completed five trials of ascent and descent using three different stepping patterns: 1) SBSL, 2) SBST, and 3) SOS. Kinematics and kinetics were collected with an optoelectronic motion-tracking system and a force plate embedded into a four-step staircase. An inverse-dynamics link-segment model (QGAIT system) was used to calculate the net joint kinetics.
During stair ascent, different peak anteroposterior (AP) forces were observed across all three stepping patterns (SOS > SBSL > SBST, P < 0.05). During ascent, the flexion moments of SOS (0.96 N x m x kg(-1)) and SBSL (0.97 N x m x kg(-1)) patterns were similar and much larger than the SBST moments (0.14 N x m x kg(-1)). In the descent conditions, the initial AP peak force for SOS was larger than that of SBSL and SBST. However, the second peak force for SOS (4.92 N x kg(-1)) and SBST (4.68 N x kg(-1)) were larger than SBSL (1.57 N x kg(-1)). During descent, the initial peak flexion moment for the SOS pattern was larger than SBSL and SBST, whereas during the second peak, SOS (1.05 N x m x kg(-1)) and SBST (1.11 N x m x kg(-)) were no different and larger than SBSL (0.18 N x m x kg(-1)).
Overall, SBSL during ascent and SBST during descent had the highest loads. These results increase our understanding of alternative stepping patterns and have important clinical (reduction of loading on injured/diseased leg) and rehabilitation implications.
本研究比较了传统的一步跨过一步（SOS）以及代偿性的一步接一步的领先腿（SBSL）和跟随腿（SBST）上楼梯行走模式下膝关节的运动学和动力学。
17名（男性9名）健康成年人使用三种不同的行走模式完成了五次上下楼梯试验：1）SBSL，2）SBST，3）SOS。使用光电运动跟踪系统和嵌入四步楼梯的测力板收集运动学和动力学数据。使用逆动力学环节段模型（QGAIT系统）计算净关节动力学。
在上楼梯过程中，在所有三种行走模式中观察到不同的前后（AP）力峰值（SOS > SBSL > SBST，P < 0.05）。在上楼梯过程中，SOS（0.96 N·m·kg⁻¹）和SBSL（0.97 N·m·kg⁻¹）模式的屈曲力矩相似，且远大于SBST模式的力矩（0.14 N·m·kg⁻¹）。在下楼梯情况下，SOS的初始AP峰值力大于SBSL和SBST。然而，SOS（4.92 N·kg⁻¹）和SBST（4.68 N·kg⁻¹）的第二个峰值力大于SBSL（1.57 N·kg⁻¹）。在下楼梯过程中，SOS模式的初始峰值屈曲力矩大于SBSL和SBST，而在第二个峰值期间，SOS（1.05 N·m·kg⁻¹）和SBST（1.11 N·m·kg⁻¹）没有差异且大于SBSL（0.18 N·m·kg⁻¹）。
总体而言，上楼梯时的SBSL和下楼梯时的SBST负荷最高。这些结果增进了我们对替代行走模式的理解，并具有重要的临床意义（减轻受伤/患病腿部的负荷）和康复意义。
