Peng H-T, Chen W C, Kernozek T W, Kim K, Song C-Y
Physical Education, Chinese Culture University, Taipei, Taiwan.
Dance, Chinese Culture University, Taipei, Taiwan.
Int J Sports Med. 2015 Aug;36(9):747-53. doi: 10.1055/s-0035-1547220. Epub 2015 Mar 25.
This study investigated the influence of patellofemoral pain (PFP) and fatigue on lower-extremity joint biomechanics in female dancers during consecutive simple ground échappé. 3-dimensional joint mechanics were analyzed from the no-fatigue to fatigue conditions. 2-way mixed ANOVAs were used to compare the differences of the kinematic and kinetic variables between groups and conditions. Group main effects were seen in increased jump height (p=0.03), peak vertical ground reaction force (p=0.01), knee joint power absorption (p=0.04), and patellofemoral joint stress (PFJS, p=0.04) for PFP group. Fatigue main effects were found for decreased jump height (p<0.01), decreased ankle plantarflexion at initial foot-ground contact (p=0.01), and decreased ankle displacement (p<0.01). Hip external rotation impulse and hip joint stiffness increased (both p<0.01) while knee extension and external rotation moment, and ankle joint power absorption decreased (p<0.01, p=0.02, p<0.01, respectively) after fatigue. The peak PFJS also decreased after fatigue (p<0.01). Female ballet dancers with PFP sustained great ground impact and loads on the knee probably due to higher jump height compared to the controls. All dancers presented diminished knee joint loading for the protective mechanism and endurance of ankle joint musculature required for the dissipation of loads and displayed a distal-to-proximal dissipation strategy after fatigue.
本研究调查了髌股疼痛（PFP）和疲劳对女性舞蹈演员在连续简单地面 échappé 动作中下肢关节生物力学的影响。分析了从无疲劳状态到疲劳状态下的三维关节力学。采用双向混合方差分析来比较组间和不同状态下运动学和动力学变量的差异。PFP 组在跳跃高度增加（p = 0.03）、垂直地面反作用力峰值（p = 0.01）、膝关节功率吸收（p = 0.04）和髌股关节应力（PFJS，p = 0.04）方面出现组间主效应。疲劳的主效应表现为跳跃高度降低（p < 0.01）、初始脚触地时踝关节跖屈减少（p = 0.01）以及踝关节位移减少（p < 0.01）。疲劳后，髋关节外旋冲量和髋关节刚度增加（均 p < 0.01），而膝关节伸展和外旋力矩以及踝关节功率吸收减少（分别为 p < 0.01、p = 0.02、p < 0.01）。疲劳后 PFJS 峰值也降低（p < 0.01）。与对照组相比，患有 PFP 的女性芭蕾舞演员可能由于跳跃高度较高，膝关节承受了更大的地面冲击和负荷。所有舞者在疲劳后，由于负荷消散所需的踝关节肌肉组织的保护机制和耐力，膝关节负荷减小，并表现出从远端到近端的负荷消散策略。
