Stettler Matthias, Luder Gere, Schmid Stefan, Mueller Mebes Christine, Stutz Ursula, Ziswiler Hans-Rudolf, Radlinger Lorenz
Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland.
Int J Rheum Dis. 2018 Oct;21(10):1756-1762. doi: 10.1111/1756-185X.12917. Epub 2016 Jul 26.
Generalized joint hypermobility (GJH) is a frequent entity, which is still not fully understood. Symptoms associated with GJH are musculoskeletal disorders, decreased balance, impaired proprioception and chronic pain. The purpose of this study was to compare the passive anterior tibial translation (TT) in terms of distance and corresponding force between normomobile (NM) and hypermobile (HM) as well as between NM, symptomatic (HM-s) and asymptomatic (HM-as) hypermobile women.
A total of 195 women, 67 NM and 128 HM, whereof 56 were further classified as HM-s and 47 as HM-as, participated in this study. Passive TT was measured using an adapted Rolimeter. A manual traction force was applied and the distance of the translation measured. For the analysis, maximal translation (TTmax) and the respective force as well as the distance at 40N (TTF40) and 80N (TTF80) traction force were determined. The NM and HM groups were compared using independent samples t-tests, whereas the NM, HM-s and HM-as groups were compared using one-way analyses of variance with Tukey post hoc tests (significance level P ≤ 0.05).
Comparisons revealed higher values for the variables TTmax, TTF40 and TTF80 in the HM compared to the NM group. In addition, TTmax and TTF80 were found to be higher in the HM-s compared to the NM group.
HM women showed significantly higher TT distances, which were even more accentuated in those having symptoms. The findings point toward less passive stability of the knee joint and thus maybe a need of higher muscle activation in order to stabilize the joint.
全身性关节活动过度(GJH)是一种常见情况,但仍未被完全理解。与GJH相关的症状包括肌肉骨骼疾病、平衡能力下降、本体感觉受损和慢性疼痛。本研究的目的是比较正常活动(NM)和活动过度(HM)女性之间以及NM、有症状的活动过度(HM-s)和无症状的活动过度(HM-as)女性之间在被动胫骨前移(TT)的距离和相应力量方面的差异。
共有195名女性参与本研究,其中67名NM女性和128名HM女性,后者中有56名被进一步分类为HM-s,47名被分类为HM-as。使用改良的旋转计测量被动TT。施加手动牵引力并测量平移距离。分析时,确定最大平移(TTmax)和相应的力以及在40N(TTF40)和80N(TTF80)牵引力下的距离。使用独立样本t检验比较NM组和HM组,而使用单因素方差分析和Tukey事后检验比较NM组、HM-s组和HM-as组(显著性水平P≤0.05)。
比较显示,与NM组相比,HM组的TTmax、TTF40和TTF80变量值更高。此外,与NM组相比,HM-s组的TTmax和TTF80更高。
活动过度的女性表现出明显更长的TT距离,在有症状的女性中更为突出。这些发现表明膝关节的被动稳定性较低,因此可能需要更高的肌肉激活来稳定关节。