Araújo Vanessa Lara, Souza Thales Rezende, Carvalhais Viviane Otoni do Carmo, Cruz Aline Castro, Fonseca Sérgio Teixeira
Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Clin Biomech (Bristol). 2017 May;44:28-35. doi: 10.1016/j.clinbiomech.2017.02.012. Epub 2017 Feb 27.
Strengthening of the hip and trunk muscles has the potential to change lower limb kinematic patterns, such as excessive hip medial rotation and adduction during weight-bearing tasks. This study aimed to investigate the effect of hip and trunk muscles strengthening on hip muscle performance, hip passive properties, and lower limb kinematics during step-down task in women.
Thirty-four young women who demonstrated dynamic knee valgus during step-down were divided into two groups. The experimental group underwent three weekly sessions of strengthening exercises for eight weeks, and the control group continued their usual activities. The following evaluations were carried out: (a) isokinetic maximum concentric and eccentric work of hip lateral rotators, (b) isokinetic hip passive torque of lateral rotation and resting transverse plane position, and (c) three-dimensional kinematics of the lower limb during step-down.
The strengthening program increased concentric (P<0.001) and eccentric (P<0.001) work of hip lateral rotators, and changed hip resting position toward lateral rotation (P<0.001). The intervention did not significantly change hip passive torque (P=0.089, main effect). The program reduced hip (P=0.002), thigh (P=0.024) and shank (P=0.005) adduction during step-down task. Hip, thigh and knee kinematics in transverse plane and foot kinematics in frontal plane did not significantly modify after intervention (P≥0.069, main effect).
Hip and trunk strengthening reduced lower limb adduction during step-down. The changes in hip maximum work and resting position may have contributed to the observed kinematic effects.
加强臀部和躯干肌肉可能会改变下肢运动学模式，例如在负重任务期间出现过度的髋关节内旋和内收。本研究旨在调查加强臀部和躯干肌肉对女性下楼梯任务期间臀部肌肉性能、臀部被动特性和下肢运动学的影响。
34名在下楼梯时表现出动态膝外翻的年轻女性被分为两组。实验组进行为期八周、每周三次的强化训练，对照组继续其日常活动。进行了以下评估：(a) 髋关节外旋肌的等速最大向心和离心功；(b) 外旋和静息横平面位置的等速髋关节被动扭矩；(c) 下楼梯期间下肢的三维运动学。
强化训练增加了髋关节外旋肌的向心功（P<0.001）和离心功（P<0.001），并使髋关节静息位置向外旋方向改变（P<0.001）。干预并未显著改变髋关节被动扭矩（P=0.089，主效应）。该训练减少了下楼梯任务期间的髋关节内收（P=0.002）、大腿内收（P=0.024）和小腿内收（P=0.005）。干预后，横平面内的髋关节、大腿和膝关节运动学以及额平面内的足部运动学没有显著改变（P≥0.069，主效应）。
加强臀部和躯干肌肉可减少下楼梯期间的下肢内收。髋关节最大功和静息位置的变化可能促成了观察到的运动学效应。
