Zaslow Tracy L, Pace J Lee, Mueske Nicole M, Chua Matthew C, Katzel Mia J, Dennis Sandra W, Wren Tishya A L
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA; Orthopaedic Surgery Department, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Gait Posture. 2016 Feb;44:189-93. doi: 10.1016/j.gaitpost.2015.12.019. Epub 2015 Dec 21.
This study compared three-dimensional (3-D) hip and knee kinematics and kinetics between lateral shuffle and side-step cutting movements to determine whether the simpler lateral shuffle movement can be used in place of cutting to assess knee injury risk. A total of 78 patients (52 female) and 34 controls (16 female) aged 8-19 years performed lateral shuffle and 45° side-step cutting movements. Hip and knee kinematics and kinetics between initial contact and peak knee flexion were calculated using the Plug-in-Gait model and compared between activities using Pearson's correlation and paired t-tests. Peak knee valgus angle correlated strongly (r=0.86, p<0.0001), while minimum (r=0.25, p=0.0001) and peak hip abduction (r=0.24, p=0.0003), and peak hip internal rotation (r=0.33, p<0.0001) correlated only weakly between the two activities. Peak external knee valgus moment (r=0.32, p<0.0001) and average external knee (r=0.42, p<0.0001) and hip (r=0.37, p<0.0001) flexion moments correlated weakly to moderately between activities. Subjects were more internally rotated (3.6°, p<0.0001) and less abducted (16.7° and 17.3° for minimum and maximum, p<0.0001) at the hip during cutting, with higher hip (0.12, p<0.0001) and lower knee (-0.02, p=0.0001) non-dimensional flexion moments. These results suggest that the lateral shuffle movement may be useful for evaluating knee valgus, particularly during initial visual assessment. However, the lateral shuffle may not be challenging enough to reveal poor neuromuscular control over hip ab/adduction and rotation, necessitating follow-up assessment of cutting, ideally using 3-D motion analysis.
本研究比较了横向侧滑步和侧向跨步急停动作之间的三维（3-D）髋部和膝部运动学及动力学，以确定更简单的横向侧滑步动作是否可用于替代急停动作来评估膝关节损伤风险。共有78例患者（52例女性）和34名对照者（16例女性），年龄在8至19岁之间，进行了横向侧滑步和45°侧向跨步急停动作。使用插入式步态模型计算了从初始接触到膝关节屈曲峰值之间的髋部和膝部运动学及动力学，并通过Pearson相关性分析和配对t检验对不同活动之间进行了比较。膝关节外翻峰值角度相关性很强（r = 0.86，p < 0.0001），而最小（r = 0.25，p = 0.0001）和髋部外展峰值（r = 0.24，p = 0.0003）以及髋部内旋峰值（r = 0.33，p < 0.0001）在两种活动之间的相关性较弱。膝关节外翻峰值外力矩（r = 0.32，p < 0.0001）以及膝关节（r = 0.42，p < 0.0001）和髋部（r = 0.37，p < 0.0001）平均屈曲外力矩在不同活动之间的相关性为弱到中度。在急停动作期间，受试者髋部的内旋角度更大（3.6°，p < 0.0001），外展角度更小（最小和最大外展角度分别为16.
