Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Med Sci Sports Exerc. 2011 Jul;43(7):1272-9. doi: 10.1249/MSS.0b013e3182074de9.
The aim of this study was to identify differences in knee range of motion (ROM), movement speed, ground reaction forces (GRF) profile, neuromuscular activity, and muscle coactivation during the transition between stair descent and level walking in meniscectomized patients at high risk of knee osteoarthritis (OA) compared with the nonoperated leg and with healthy controls.
A total of 22 meniscectomized patients (15 men and 7 women (mean±SD), 45.4±5.1 yr, 174.3±7.1 cm, 77.3±15.4 kg) and 26 healthy controls (16 men and 10 women, 45.6±6.1 yr, 174.9±8.1 cm, 78.6±16.8 kg) were tested using synchronous force plate, goniometer, and EMG recording (vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST)) during the transition step between stair descent and level walking. Pain was assessed using the Knee Injury and Osteoarthritis Outcome Score.
Patients reported more pain than controls (P≤0.001), but no differences were observed between patients and controls in any variables including knee ROM during stance (operated leg=42.9°, nonoperated leg=44.3°, controls=43.4°, respectively, P=0.42). A shorter stance phase (Tstance; 657 vs 679 ms) was observed for the meniscectomized leg versus the nonoperated leg in patients along with reduced overall medial versus lateral thigh muscle activity in the meniscectomized leg during the weight acceptance phase (P≤0.05) and at peak GRF (P≤0.01).
Patients and controls did not differ in any of the examined variables. However, kinematic differences were observed in the meniscectomized leg compared with the nonoperated leg along with attenuated medial leg muscle activity in the meniscectomized leg. The present findings support the hypothesis that meniscectomized individuals demonstrate early modulations in kinematics and neuromuscular activity that may represent an initial phase in the development of knee OA.
本研究旨在比较膝关节半月板切除术(meniscectomy)高风险骨关节炎(OA)患者、非手术侧膝关节和健康对照组在从楼梯下降过渡到水平步行时膝关节活动范围(ROM)、运动速度、地面反作用力(GRF)曲线、神经肌肉活动和肌肉协同收缩的差异。
共纳入 22 例膝关节半月板切除术患者(15 名男性和 7 名女性,平均年龄±标准差为 45.4±5.1 岁,平均身高 174.3±7.1cm,平均体重 77.3±15.4kg)和 26 例健康对照组(16 名男性和 10 名女性,平均年龄±标准差为 45.6±6.1 岁,平均身高 174.9±8.1cm,平均体重 78.6±16.8kg)。使用同步测力板、量角器和肌电图(股外侧肌(VL)、股内侧肌(VM)、股二头肌(BF)、半腱肌(ST))记录在从楼梯下降过渡到水平步行时的过渡阶段。使用膝关节损伤和骨关节炎结果评分(Knee Injury and Osteoarthritis Outcome Score)评估疼痛情况。
患者报告的疼痛比对照组更严重(P≤0.001),但在任何变量中,包括在支撑阶段的膝关节 ROM(手术侧=42.9°,非手术侧=44.3°,对照组=43.4°,P=0.42),患者和对照组之间均无差异。与非手术侧相比,半月板切除术患者的支撑阶段(Tstance)更短(657 毫秒比 679 毫秒),并且在接受体重阶段(P≤0.05)和峰值 GRF 时(P≤0.01),半月板切除术侧的大腿内、外侧肌肉活动整体减少。
在研究的所有变量中,患者和对照组均无差异。然而,与非手术侧相比,半月板切除术侧的运动学差异,以及半月板切除术侧的大腿内肌肉活动减弱。本研究结果支持这样的假设,即半月板切除术患者表现出运动学和神经肌肉活动的早期调节,这可能是膝关节 OA 发展的初始阶段。