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有和没有髌股疼痛的患者的躯干生物力学及其与髋和膝关节运动学的关联。

Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain.

作者信息

Nakagawa Theresa Helissa, Maciel Carlos Dias, Serrão Fábio Viadanna

机构信息

Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.

Department of Electrical Engineering, University of São Paulo, São Carlos, SP, Brazil.

出版信息

Man Ther. 2015 Feb;20(1):189-93. doi: 10.1016/j.math.2014.08.013. Epub 2014 Sep 9.

Abstract

Patellofemoral pain (PFP) is a common lower extremity condition observed in sports clinics. Recently, it has been suggested that trunk motion could affect hip and knee biomechanics in the frontal plane. Thus, the purpose of the study was compare trunk kinematics, strength and muscle activation between people with PFP and healthy participants. In addition, the associations among trunk biomechanics, hip and knee kinematics were analysed. Thirty people with PFP and thirty pain-free individuals participated. The peak ipsilateral trunk lean, hip adduction, and knee abduction were evaluated with an electromagnetic tracking system, and the surface electromyographic signals of the iliocostalis and external oblique muscle were recorded during single-leg squats. Trunk extension and trunk flexion with rotation isometric strength and side bridge tests were quantified using a handheld dynamometer. Compared with the control group, the PFP group demonstrated increased ipsilateral trunk lean, hip adduction and knee abduction (p = 0.02-0.04) during single-leg squat accompanied with decreased trunk isometric strength (p = < 0.001-0.009). There was no between-group difference in trunk muscle activation. Only in the control group, ipsilateral trunk lean was significantly correlated with hip adduction (r = -0.66) and knee abduction (r = 0.49); also, the side bridge test correlated with knee abduction (r = -0.51). Differences in trunk, hip and knee biomechanics were found in people with PFP. No relationship among trunk, hip and knee biomechanics was found in the PFP group, suggesting that people with PFP show different movement patterns compared to the control group.

摘要

髌股疼痛(PFP)是运动诊所中常见的下肢病症。最近,有人提出躯干运动可能会影响额状面的髋部和膝部生物力学。因此,本研究的目的是比较PFP患者与健康参与者之间的躯干运动学、力量和肌肉激活情况。此外,还分析了躯干生物力学、髋部和膝部运动学之间的关联。30名PFP患者和30名无疼痛个体参与了研究。使用电磁跟踪系统评估同侧躯干倾斜、髋部内收和膝部外展的峰值,并在单腿深蹲过程中记录髂肋肌和腹外斜肌的表面肌电信号。使用手持测力计对躯干伸展、躯干旋转屈曲等长力量和侧桥测试进行量化。与对照组相比,PFP组在单腿深蹲时同侧躯干倾斜、髋部内收和膝部外展增加(p = 0.02 - 0.04),同时躯干等长力量下降(p = < 0.001 - 0.009)。两组之间躯干肌肉激活没有差异。仅在对照组中,同侧躯干倾斜与髋部内收(r = -0.66)和膝部外展(r = 0.49)显著相关;此外,侧桥测试与膝部外展相关(r = -0.51)。PFP患者在躯干、髋部和膝部生物力学方面存在差异。在PFP组中未发现躯干、髋部和膝部生物力学之间的关系,这表明PFP患者与对照组相比表现出不同的运动模式。

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