Wesseling Mariska, de Groote Friedl, Meyer Christophe, Corten Kristoff, Simon Jean-Pierre, Desloovere Kaat, Jonkers Ilse
Department of Kinesiology, KU Leuven, Human Movement Biomechanics, Heverlee, Belgium.
Department of Mechanical Engineering, KU Leuven, Division PMA, Heverlee, Belgium.
J Orthop Res. 2015 Jul;33(7):1094-102. doi: 10.1002/jor.22852. Epub 2015 Apr 14.
Patients with hip pathology present alterations in gait which have an effect on joint moments and loading. In knee osteoarthritic patients, the relation between medial knee contact forces and the knee adduction moment are currently being exploited to define gait retraining strategies to effectively reduce pain and disease progression. However, the relation between hip contact forces and joint moments has not been clearly established. Therefore, this study aims to investigate the effect of changes in hip and pelvis kinematics during gait on internal hip moments and contact forces which is calculated using muscle driven simulations. The results showed that frontal plane kinetics have the largest effect on hip contact forces. Given the high correlation between the change in hip adduction moment and contact force at initial stance (R(2) = 0.87), this parameter can be used to alter kinematics and predict changes in contact force. At terminal stance the hip adduction and flexion moment can be used to predict changes in contact force (R(2) = 0.76). Therefore, gait training that focuses on decreasing hip adduction moments, a wide base gait pattern, has the largest potential to reduce hip contact forces.
患有髋部疾病的患者会出现步态改变，这会影响关节力矩和负荷。在膝骨关节炎患者中，目前正在研究内侧膝关节接触力与膝关节内收力矩之间的关系，以确定有效的步态再训练策略，从而减轻疼痛并延缓疾病进展。然而，髋部接触力与关节力矩之间的关系尚未明确确立。因此，本研究旨在利用肌肉驱动模拟来研究步态期间髋部和骨盆运动学变化对髋部内力矩和接触力的影响。结果表明，额面动力学对髋部接触力影响最大。鉴于初始站立时髋部内收力矩变化与接触力之间具有高度相关性（R² = 0.87），该参数可用于改变运动学并预测接触力变化。在终末站立时，髋部内收和屈曲力矩可用于预测接触力变化（R² = 0.76）。因此，专注于减小髋部内收力矩的步态训练（宽基底步态模式）最有可能降低髋部接触力。
