Gribbin Timothy C, Slater Lindsay V, Herb C Collin, Hart Joseph M, Chapman Ryan M, Hertel Jay, Kuenze Christopher M
Department of Kinesiology, University of Virginia, Charlottesville, VA 22904, USA.
Department of Kinesiology, University of Virginia, Charlottesville, VA 22904, USA.
Clin Biomech (Bristol). 2016 Feb;32:64-71. doi: 10.1016/j.clinbiomech.2016.01.006. Epub 2016 Jan 23.
After anterior cruciate ligament injury, patients have increased risk for developing degenerative osteoarthritis, potentially due to the kinematic changes that persist after surgical reconstruction. Current research only describes single joint kinematic differences rather than the way in which two joints behave concurrently, termed joint coupling. The purpose of this study was to compare knee motion relative to hip motion in anterior cruciate ligament reconstructed and healthy limbs during walking and jogging.
Thirty-seven recreationally active volunteers (22 reconstructed, 15 healthy) walked and jogged at 4.83 km/h and 9.66 km/h respectively. Vector coding methods were used to calculate stride-to-stride variability, magnitude, and vector angle of 6 joint couples during walking and jogging: hip frontal-knee frontal planes, hip frontal-knee sagittal, hip frontal-knee transverse, hip sagittal-knee frontal, hip sagittal-knee transverse, and hip transverse-knee frontal planes.
The hip sagittal-knee frontal and hip sagittal-knee transverse joint couples had decreased variability during mid-stance, and all other couples had increased variability during the stance phase in the reconstructed group. The reconstructed group had decreased magnitude of joint excursion in the hip frontal-knee sagittal couple during all phases of gait during walking. Vector angles of the hip frontal-knee transverse couple increased in the reconstructed group during the loading, middle, and terminal stance phases, and swing phase of gait during walking.
The increased variability and decreased magnitude of joint excursion indicate that movement patterns were less consistent during walking gait despite employing a more constrained system during movement in the reconstructed limb compared to healthy controls.
前交叉韧带损伤后,患者发生退行性骨关节炎的风险增加,这可能是由于手术重建后持续存在的运动学变化所致。目前的研究仅描述了单个关节的运动差异,而非两个关节同时运动的方式,即关节耦合。本研究的目的是比较前交叉韧带重建肢体和健康肢体在步行和慢跑过程中膝关节相对于髋关节的运动情况。
37名有运动习惯的志愿者(22名重建组,15名健康组)分别以4.83公里/小时和9.66公里/小时的速度步行和慢跑。采用矢量编码方法计算步行和慢跑过程中6对关节耦合的步幅间变异性、幅度和矢量角度,这6对关节耦合分别为:髋关节额状面-膝关节额状面、髋关节额状面-膝关节矢状面、髋关节额状面-膝关节横断面、髋关节矢状面-膝关节额状面、髋关节矢状面-膝关节横断面、髋关节横断面-膝关节额状面。
重建组中,髋关节矢状面-膝关节额状面和髋关节矢状面-膝关节横断面关节耦合在站立中期的变异性降低,而其他所有关节耦合在站立期的变异性增加。重建组在步行过程中所有步态阶段,髋关节额状面-膝关节矢状面关节耦合的关节活动幅度均降低。重建组在步行过程中的负重、中间和末期站立阶段以及摆动期,髋关节额状面-膝关节横断面关节耦合的矢量角度增加。
关节活动幅度的变异性增加和幅度降低表明,尽管与健康对照组相比,重建肢体在运动过程中采用了更受限的系统,但步行步态中的运动模式仍不太一致。