Grenholm Anton, Stensdotter Ann-Katrin, Häger-Ross Charlotte
Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-901 87 Umeå, Sweden.
Clin Biomech (Bristol). 2009 Jan;24(1):88-94. doi: 10.1016/j.clinbiomech.2008.09.004. Epub 2008 Nov 4.
Compensatory movement strategies may develop in response to pain to avoid stress on the affected area. Patellofemoral pain is characterised by intermittent periods of pain and the present study addresses whether long-term pain leads to compensatory movement strategies that remain even when the pain is absent.
Lower extremity kinematics in three dimensions was studied in stair descent in 17 women with patellofemoral and in 17 matched controls. A two-dimensional geometric model was constructed to normalise kinematic data for subjects with varying anthropometrics when negotiating stairs of fixed proportions.
There were minor differences in movement patterns between groups. Knee joint angular velocity in the stance leg at foot contact was lower and the movement trajectory tended to be jerkier in the patellofemoral group. The two-dimensional model showed greater plantar flexion in the swing leg in preparation for foot placement in the patellofemoral group.
The results indicate that an altered stair descent strategy in the patellofemoral group may remain also in the absence of pain. The biomechanical interpretation presumes that the strategy is aimed to reduce knee joint loading by less knee joint moment and lower impact force.
代偿性运动策略可能因疼痛而产生，以避免患区承受压力。髌股疼痛的特点是间歇性疼痛，本研究探讨长期疼痛是否会导致即使疼痛消失仍持续存在的代偿性运动策略。
对17名患有髌股疼痛的女性和17名匹配的对照组女性在楼梯下行过程中的下肢三维运动学进行了研究。构建了一个二维几何模型，以便在受试者通过固定比例楼梯时，对不同人体测量学特征的受试者的运动学数据进行标准化。
两组之间的运动模式存在细微差异。髌股组中支撑腿在足接触时的膝关节角速度较低，运动轨迹往往更不平稳。二维模型显示，髌股组中摆动腿在准备足部着地时跖屈幅度更大。
结果表明，髌股组中改变的楼梯下行策略在疼痛消失时可能依然存在。生物力学解释假定该策略旨在通过减少膝关节力矩和降低冲击力来减轻膝关节负荷。
