Willy R W, Buchenic L, Rogacki K, Ackerman J, Schmidt A, Willson J D
Department of Physical Therapy, East Carolina University, Greenville, North Carolina, USA.
Division of Physical Therapy, Ohio University, Athens, Ohio, USA.
Scand J Med Sci Sports. 2016 Feb;26(2):197-205. doi: 10.1111/sms.12413. Epub 2015 Feb 4.
We sought to determine if an in-field gait retraining program can reduce excessive impact forces and peak hip adduction without adverse changes in knee joint work during running. Thirty healthy at-risk runners who exhibited high-impact forces were randomized to retraining [21.1 (± 1.9) years, 22.1 (± 10.8) km/week] or control groups [21.0 (± 1.3) years, 23.2 (± 8.7) km/week]. Retrainers were cued, via a wireless accelerometer, to increase preferred step rate by 7.5% during eight training sessions performed in-field. Adherence with the prescribed step rate was assessed via mobile monitoring. Three-dimensional gait analysis was performed at baseline, after retraining, and at 1-month post-retraining. Retrainers increased step rate by 8.6% (P < 0.0001), reducing instantaneous vertical load rate (-17.9%, P = 0.003), average vertical load rate (-18.9%, P < 0.0001), peak hip adduction (2.9° ± 4.2 reduction, P = 0.005), eccentric knee joint work per stance phase (-26.9%, P < 0.0001), and per kilometer of running (-21.1%, P < 0.0001). Alterations in gait were maintained at 30 days. In the absence of any feedback, controls maintained their baseline gait parameters. The majority of retrainers were adherent with the prescribed step rate during in-field runs. Thus, in-field gait retraining, cueing a modest increase in step rate, was effective at reducing impact forces, peak hip adduction and eccentric knee joint work.
我们试图确定一项现场步态再训练计划是否能在不改变跑步时膝关节做功的情况下,降低过度冲击力和峰值髋关节内收。30名表现出高冲击力的健康高危跑步者被随机分为再训练组[年龄21.1(±1.9)岁,每周跑量22.1(±10.8)公里]和对照组[年龄21.0(±1.3)岁,每周跑量23.2(±8.7)公里]。在八次现场训练中,通过无线加速度计提示再训练组跑步者将步频提高7.5%。通过移动监测评估对规定步频的依从性。在基线、再训练后以及再训练后1个月进行三维步态分析。再训练组步频提高了8.6%(P<0.0001),瞬时垂直负荷率降低了17.9%(P = 0.003),平均垂直负荷率降低了18.9%(P<0.0001),峰值髋关节内收减少了2.9°±4.2(P = 0.005),每个站立阶段的膝关节离心做功减少了26.9%(P<0.0001),每公里跑步的膝关节离心做功减少了21.1%(P<0.0001)。步态改变在30天时得以维持。在没有任何反馈的情况下,对照组保持其基线步态参数。大多数再训练组跑步者在现场跑步时依从规定的步频。因此,现场步态再训练,提示适度提高步频,在降低冲击力、峰值髋关节内收和膝关节离心做功方面是有效的。