Vannatta Charles Nathan, Kernozek Thomas W, Gheidi Naghmeh
Department of Sports Physical Therapy, Gundersen Health Systems, 3111 Gundersen Drive, Onalaska, WI 54650, United States.
Health Professions, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI 54651, United States.
Gait Posture. 2017 Oct;58:240-245. doi: 10.1016/j.gaitpost.2017.08.005. Epub 2017 Aug 9.
Gait retraining is a common form of treatment for running related injuries. Proximal factors at the hip have been postulated as having a role in the development of running related injuries. How altering footstrike affects hip muscles forces and kinematics has not been described. Thus, we aimed to quantify differences in hip muscle forces and hip kinematics that may occur when healthy runners are instructed to alter their foot strike pattern from their habitual rear-foot strike to a forefoot strike. This may gain insight on the potential etiology and treatment methods of running related lower extremity injury. Twenty-five healthy female runners completed a minimum of 10 running trials in a controlled laboratory setting under rear-foot strike and instructed forefoot strike conditions. Kinetic and kinematic data were used in an inverse dynamic based static optimization to estimate individual muscle forces during running. Within subject differences were investigated using a repeated measures multi-variate analysis of variance. Peak gluteus medius and minimus and hamstring forces were reduced while peak gluteus maximus force was increased when running with an instructed forefoot strike pattern. Peak hip adduction, hip internal rotation, and heel-COM distance were also reduced. Therefore, instructing habitual rearfoot strike runners to run with a forefoot strike pattern resulted in changes in peak gluteal and hamstring muscle forces and hip kinematics. These changes may be beneficial to the development and treatment of running related lower extremity injury.
步态再训练是治疗跑步相关损伤的常见方法。髋关节的近端因素被认为在跑步相关损伤的发生中起作用。然而，改变着地方式如何影响髋部肌肉力量和运动学尚未见报道。因此，我们旨在量化健康跑步者在被指示将其着地方式从习惯的后足着地改为前足着地时，髋部肌肉力量和髋部运动学可能出现的差异。这可能有助于深入了解跑步相关下肢损伤的潜在病因和治疗方法。25名健康女性跑步者在受控实验室环境下，在后足着地和指示的前足着地条件下，至少完成了10次跑步试验。动力学和运动学数据用于基于逆动力学的静态优化，以估计跑步过程中的个体肌肉力量。使用重复测量多变量方差分析研究受试者内部差异。当按照指示的前足着地方式跑步时，臀中肌、臀小肌和腘绳肌的峰值力量降低，而臀大肌的峰值力量增加。髋部内收、髋部内旋和足跟-重心距离的峰值也降低。因此，指示习惯后足着地的跑步者采用前足着地方式会导致臀肌和腘绳肌峰值力量以及髋部运动学的变化。这些变化可能对跑步相关下肢损伤的发展和治疗有益。
