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深蹲任务中伴有和不伴有凸轮型股骨髋臼撞击症的人群的髋关节运动学和动力学

Hip kinematics and kinetics in persons with and without cam femoroacetabular impingement during a deep squat task.

作者信息

Bagwell Jennifer J, Snibbe Jason, Gerhardt Michael, Powers Christopher M

机构信息

Division of Biokinesiology & Physical Therapy, University of Southern California, 1540 Alcazar Street, CHP-155, Los Angeles, CA 90740, USA.

Snibbe Orthopedics, 120 South Spalding, Beverly Hills, CA 90212, USA.

出版信息

Clin Biomech (Bristol). 2016 Jan;31:87-92. doi: 10.1016/j.clinbiomech.2015.09.016. Epub 2015 Sep 25.

Abstract

BACKGROUND

Previous studies have indicated that hip and pelvis kinematics may be altered during functional tasks in persons with femoroacetabular impingement. The purpose of this study was to compare hip and pelvis kinematics and kinetics during a deep squat task between persons with cam femoroacetabular impingement and pain-free controls.

METHODS

Fifteen persons with cam femoroacetabular impingement and 15 persons without cam femoroacetabular impingement performed a deep squat task. Peak hip flexion, abduction, and internal rotation, and mean hip extensor, adductor, and external rotator moments were quantified. Independent t-tests (α<0.05) were used to evaluate between group differences.

FINDINGS

Compared to the control group, persons with cam femoroacetabular impingement demonstrated decreased peak hip internal rotation (15.2° (SD 9.5°) vs. 9.4° (SD 7.8°); P=0.041) and decreased mean hip extensor moments (0.56 (SD 0.12) Nm/kg vs. 0.45 (SD 0.15) Nm/kg; P=0.018). In addition persons in the cam femoroacetabular impingement group demonstrated decreased posterior pelvis tilt during squat descent compared to the control group, resulting in a more anteriorly tilted pelvis at the time peak hip flexion (12.5° (SD 17.1°) vs. 23.0° (SD 12.4°); P=0.024).

INTERPRETATION

The decreased hip internal rotation observed in persons with cam femoroacetabular impingement may be the result of bony impingement. Furthermore, the decrease in posterior pelvis tilt may contribute to impingement by further approximating the femoral head-neck junction with the acetabulum. Additionally, decreased hip extensor moments suggest that diminished hip extensor muscle activity may contribute to decreased posterior pelvis tilt.

摘要

背景

先前的研究表明,在股骨髋臼撞击症患者进行功能性任务时,髋部和骨盆的运动学可能会发生改变。本研究的目的是比较凸轮型股骨髋臼撞击症患者与无疼痛对照组在深蹲任务期间的髋部和骨盆运动学及动力学。

方法

15名凸轮型股骨髋臼撞击症患者和15名无凸轮型股骨髋臼撞击症患者进行了深蹲任务。对髋部最大屈曲、外展和内旋角度,以及髋部伸肌、内收肌和外旋肌的平均力矩进行了量化。采用独立t检验(α<0.05)评估组间差异。

结果

与对照组相比,凸轮型股骨髋臼撞击症患者的髋部最大内旋角度减小(15.2°(标准差9.5°)对9.4°(标准差7.8°);P=0.041),髋部伸肌平均力矩减小(0.56(标准差0.12)牛米/千克对0.45(标准差0.15)牛米/千克;P=0.018)。此外,与对照组相比,凸轮型股骨髋臼撞击症组患者在深蹲下降过程中骨盆后倾减小,导致在髋部最大屈曲时骨盆前倾增加(12.5°(标准差17.1°)对23.0°(标准差12.4°);P=0.024)。

解读

在凸轮型股骨髋臼撞击症患者中观察到的髋部内旋减小可能是骨撞击的结果。此外,骨盆后倾的减小可能通过使股骨头-颈交界处与髋臼进一步靠近而导致撞击。此外,髋部伸肌平均力矩减小表明髋部伸肌肌肉活动减弱可能导致骨盆后倾减小。

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