Luc-Harkey Brittney A, Harkey Matthew S, Stanley Laura E, Blackburn J Troy, Padua Darin A, Pietrosimone Brian
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Clin Biomech (Bristol). 2016 Nov;39:9-13. doi: 10.1016/j.clinbiomech.2016.08.011. Epub 2016 Aug 24.
Alterations in mechanical loading following anterior cruciate ligament reconstruction may lead to the development of knee osteoarthritis. Feedback that cues a change in knee kinematics during walking gait may influence mechanical loading, yet it remains unknown if knee kinematics predict kinetics during walking gait. Our aim was to determine if sagittal plane knee kinematics predict kinetics during walking gait in anterior cruciate ligament reconstructed individuals.
Forty-one individuals with a history of primary, unilateral anterior cruciate ligament reconstruction completed a motion capture walking gait analysis. Hierarchical linear regression analyses were used in order to determine the amount of variance in the kinetic variables of interest (peak vertical ground reaction force, instantaneous and linear vertical ground reaction force loading rate) that was individually predicted by the kinematic variables of interest (knee flexion angle at heelstrike, peak knee flexion angle, and knee flexion excursion).
Knee flexion excursion of the injured limb significantly predicted 11% of the variance in peak vGRF of the injured limb after accounting for gait speed and peak knee flexion angle (ΔR=0.11, P=0.004). After accounting for gait speed and knee flexion angle at heelstrike, knee flexion excursion significantly predicted 16% of the variance in the injured limb peak vertical ground reaction force (ΔR=0.16, P=0.001). No kinematic variable predicted vertical ground reaction force loading rate.
Altering knee flexion excursion may be useful as a future therapeutic target for modifying peak vertical ground reaction force during walking gait following anterior cruciate ligament reconstruction.
前交叉韧带重建后机械负荷的改变可能会导致膝关节骨关节炎的发展。在步行步态中提示膝关节运动学变化的反馈可能会影响机械负荷，但膝关节运动学是否能预测步行步态中的动力学仍不清楚。我们的目的是确定矢状面膝关节运动学是否能预测前交叉韧带重建个体在步行步态中的动力学。
41名有原发性单侧前交叉韧带重建病史的个体完成了运动捕捉步行步态分析。采用分层线性回归分析，以确定感兴趣的运动学变量（足跟触地时的膝关节屈曲角度、膝关节最大屈曲角度和膝关节屈曲偏移）分别预测感兴趣的动力学变量（峰值垂直地面反作用力、瞬时和线性垂直地面反作用力加载率）的方差量。
在考虑步态速度和膝关节最大屈曲角度后，患侧膝关节屈曲偏移显著预测了患侧峰值垂直地面反作用力方差的11%（ΔR=0.11，P=0.004）。在考虑步态速度和足跟触地时的膝关节屈曲角度后，膝关节屈曲偏移显著预测了患侧峰值垂直地面反作用力方差的16%（ΔR=0.16，P=0.001）。没有运动学变量能预测垂直地面反作用力加载率。
改变膝关节屈曲偏移可能作为未来治疗靶点，用于在前交叉韧带重建后的步行步态中改变峰值垂直地面反作用力。
