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正常发育儿童步态中腓肠肌内侧头相对肌束偏移与踝关节力量及工作表现的关系:一项横断面研究

Relationship of medial gastrocnemius relative fascicle excursion and ankle joint power and work performance during gait in typically developing children: A cross-sectional study.

作者信息

Martín Lorenzo Teresa, Albi Rodríguez Gustavo, Rocon Eduardo, Martínez Caballero Ignacio, Lerma Lara Sergio

机构信息

Laboratorio de Análisis del Movimiento, Hospital Infantil Universitario Niño Jesús Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón Servicio de Radiodiagnóstico, Hospital Infantil Universitario Niño Jesús Departamento de Anatomía, Histología y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Arganda del Rey Facultad de Ciencias de la Salud, CSEU La Salle, Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

Medicine (Baltimore). 2017 Jul;96(29):e7572. doi: 10.1097/MD.0000000000007572.

Abstract

Muscle fascicles lengthen in response to chronic passive stretch through in-series sarcomere addition in order to maintain an optimum sarcomere length. In turn, the muscles' force generating capacity, maximum excursion, and contraction velocity is enhanced. Thus, longer fascicles suggest a greater capacity to develop joint power and work. However, static fascicle length measurements may not be taking sarcomere length differences into account. Thus, we considered relative fascicle excursions through passive ankle dorsiflexion may better correlate with the capacity to generate joint power and work than fascicle length. Therefore, the aim of the present study was to determine if medial gastrocnemius relative fascicle excursions correlate with ankle joint power and work generation during gait in typically developing children. A sample of typically developing children (n = 10) were recruited for this study and data analysis was carried out on 20 legs. Medial gastrocnemius relative fascicle excursion from resting joint angle to maximum dorsiflexion was estimated from trigonometric relations of medial gastrocnemius pennation angle and thickness obtained from B-mode real-time ultrasonography. Furthermore, a three-dimensional motion capture system was used to obtain ankle joint work and power during the stance phase of gait. Significant correlations were found between relative fascicle excursion and peak power absorption (-) r(14) = -0.61, P = .012 accounting for 31% variability, positive work r(18) = 0.56, P = .021 accounting for 31% variability, and late stance positive work r(15) = 0.51, P = .037 accounting for 26% variability. The large unexplained variance may be attributed to mechanics of neighboring structures (e.g., soleus or Achilles tendon mechanics) and proximal joint kinetics which may also contribute to ankle joint power and work performance, and were not taken into account. Further studies are encouraged to provide greater insight on the relationship between relative fascicle excursions and joint function.

摘要

肌肉束通过串联增加肌节来响应慢性被动拉伸,从而延长,以维持最佳肌节长度。相应地,肌肉的力量产生能力、最大伸展范围和收缩速度会得到增强。因此,更长的肌肉束表明产生关节力量和做功的能力更强。然而,静态肌肉束长度测量可能没有考虑肌节长度差异。因此,我们认为通过被动踝关节背屈测量的相对肌肉束伸展幅度可能比肌肉束长度更能与产生关节力量和做功的能力相关。因此,本研究的目的是确定在发育正常的儿童中,内侧腓肠肌相对肌肉束伸展幅度与步态期间踝关节力量和做功之间是否存在关联。本研究招募了一组发育正常的儿童(n = 10),并对20条腿进行了数据分析。根据B型实时超声获得的内侧腓肠肌羽状角和厚度的三角关系,估计内侧腓肠肌从静息关节角度到最大背屈的相对肌肉束伸展幅度。此外,使用三维运动捕捉系统在步态站立期获取踝关节的做功和力量。结果发现相对肌肉束伸展幅度与峰值功率吸收(-)r(14) = -0.61,P = 0.012,解释变异为31%、正向做功r(18) = 0.56,P = 0.021,解释变异为31%以及站立后期正向做功r(15) = 0.51,P = 0.037,解释变异为26%之间存在显著相关性。较大的未解释变异可能归因于相邻结构的力学(如比目鱼肌或跟腱力学)以及近端关节动力学,它们也可能对踝关节力量和做功表现有贡献,但本研究未考虑。鼓励进一步研究以更深入了解相对肌肉束伸展幅度与关节功能之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5888/5521930/a19d8bf08675/medi-96-e7572-g001.jpg

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