Willson John D, Petrowitz Isaac, Butler Robert J, Kernozek Thomas W
East Carolina University, Department of Physical Therapy, Greenville, NC 27858, USA.
Clin Biomech (Bristol). 2012 Dec;27(10):1052-7. doi: 10.1016/j.clinbiomech.2012.08.008. Epub 2012 Sep 1.
Patellofemoral pain is one of the most common lower extremity overuse injuries in runners and is significantly more common in females. This study evaluated differences in the timing and magnitude of gluteal muscle activity as well as hip and knee joint frontal and transverse plane kinematics between male and female runners in the context of this gender bias.
Twenty healthy male and 20 healthy female runners were participants. Three-dimensional lower extremity kinematics, and gluteus medius and gluteus maximus muscle activation were recorded using motion analysis and electromyography as subjects ran at 3.7 m/s (+/-5%). Comparisons of hip and knee joint kinematic and gluteus muscle activation data were made using independent t-tests (α=0.05).
Females ran with 40% greater peak gluteus maximus activation level (P=0.028, effect size=0.79) and 53% greater average activation level (P=0.013, effect size=0.93) than males. Female runners also displayed greater hip adduction (P=.001, effect size=1.20) and knee abduction (P=0.011, effect size=0.87) angles at initial contact, greater hip adduction at peak vertical ground reaction force (P<0.001, effect size=1.31), and less knee internal rotation excursion than males (P=0.035, effect size=0.71).
Greater gluteus maximus activation levels during running may predispose females to earlier gluteus maximus fatigue, promoting altered lower extremity running kinematics thought to be associated with the etiology of patellofemoral pain. Gender differences in transverse and frontal plane hip and knee kinematics observed in this study may also contribute to the gender bias for patellofemoral pain among females.
髌股疼痛是跑步者最常见的下肢过度使用损伤之一,在女性中更为常见。本研究在这种性别差异的背景下,评估了男性和女性跑步者臀肌活动的时间和幅度以及髋关节和膝关节额状面和横断面运动学的差异。
20名健康男性和20名健康女性跑步者参与研究。当受试者以3.7米/秒(±5%)的速度跑步时,使用运动分析和肌电图记录下肢三维运动学以及臀中肌和臀大肌的肌肉激活情况。使用独立样本t检验(α=0.05)对髋关节和膝关节运动学以及臀肌激活数据进行比较。
女性跑步时臀大肌的峰值激活水平比男性高40%(P=0.028,效应量=0.79),平均激活水平比男性高53%(P=0.013,效应量=0.93)。女性跑步者在初始接触时还表现出更大的髋关节内收角度(P=0.001,效应量=1.20)和膝关节外展角度(P=0.011,效应量=0.87),在垂直地面反作用力峰值时髋关节内收更大(P<0.001,效应量=1.31),并且膝关节内旋偏移比男性少(P=0.035,效应量=0.71)。
跑步过程中较高的臀大肌激活水平可能使女性更容易出现早期臀大肌疲劳,从而导致下肢跑步运动学改变,这被认为与髌股疼痛的病因有关。本研究中观察到的髋关节和膝关节横断面和额状面运动学的性别差异也可能导致女性髌股疼痛的性别差异。