Allison Kim, Wrigley Tim V, Vicenzino Bill, Bennell Kim L, Grimaldi Alison, Hodges Paul W
The University of Melbourne, Department of Physiotherapy, 161 Barry St, Parkville, VIC 3010, Australia.
The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD 4072, Australia.
Clin Biomech (Bristol). 2016 Feb;32:56-63. doi: 10.1016/j.clinbiomech.2016.01.003. Epub 2016 Jan 15.
Lateral hip pain during walking is a feature of gluteal tendinopathy but little is known how walking biomechanics differ in individuals with gluteal tendinopathy. This study aimed to compare walking kinematics and kinetics between individuals with and without gluteal tendinopathy.
Three-dimensional walking-gait analysis was conducted on 40 individuals aged 35 to 70 years with unilateral gluteal tendinopathy and 40 pain-free controls. An analysis of covariance was used to compare kinematic and kinetic variables between groups. Linear regression was performed to investigate the relationship between kinematics and external hip adduction moment in the gluteal tendinopathy group.
Individuals with gluteal tendinopathy demonstrated a greater hip adduction moment throughout stance than controls (standardized mean difference ranging from 0.60 (first peak moment) to 0.90 (second peak moment)). Contralateral trunk lean at the time of the first peak hip adduction moment was 1.2 degrees greater (P=0.04), and pelvic drop at the second peak hip adduction moment 1.4 degrees greater (P=0.04), in individuals with gluteal tendinopathy. Two opposite trunk and pelvic strategies were also identified within the gluteal tendinopathy group. Contralateral pelvic drop was significantly correlated with the first (R=0.35) and second peak (R=0.57) hip adduction moment, and hip adduction angle with the second peak hip adduction moment (R=-0.36) in those with gluteal tendinopathy.
Individuals with gluteal tendinopathy exhibit greater hip adduction moments and alterations in trunk and pelvic kinematics during walking. Findings provide a basis to consider frontal plane pelvic control in the management of gluteal tendinopathy.
行走时臀部外侧疼痛是臀肌肌腱病的一个特征,但对于臀肌肌腱病患者的行走生物力学有何不同知之甚少。本研究旨在比较有和没有臀肌肌腱病的个体之间的行走运动学和动力学。
对40名年龄在35至70岁之间的单侧臀肌肌腱病患者和40名无疼痛的对照者进行三维步行步态分析。采用协方差分析比较两组之间的运动学和动力学变量。在臀肌肌腱病组中进行线性回归,以研究运动学与髋关节外展力矩之间的关系。
与对照组相比,臀肌肌腱病患者在整个站立期表现出更大的髋关节外展力矩(标准化平均差范围从0.60(第一个峰值力矩)到0.90(第二个峰值力矩))。在第一个髋关节外展峰值力矩时,臀肌肌腱病患者的对侧躯干倾斜度大1.2度(P = 0.04),在第二个髋关节外展峰值力矩时,骨盆下降度大1.4度(P = 0.04)。在臀肌肌腱病组中还发现了两种相反的躯干和骨盆策略。在臀肌肌腱病患者中,对侧骨盆下降与第一个(R = 0.35)和第二个峰值(R = 0.57)髋关节外展力矩显著相关,髋关节外展角度与第二个峰值髋关节外展力矩(R = -0.36)相关。
臀肌肌腱病患者在行走时表现出更大的髋关节外展力矩以及躯干和骨盆运动学的改变。研究结果为在臀肌肌腱病的治疗中考虑额状面骨盆控制提供了依据。