Jandacka Daniel, Silvernail Julia Freedman, Uchytil Jaroslav, Zahradnik David, Farana Roman, Hamill Joseph
Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Varenska 40 A, 70200 Ostrava, Czech Republic.
Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, USA.
J Foot Ankle Res. 2017 Nov 28;10:53. doi: 10.1186/s13047-017-0235-0. eCollection 2017.
BACKGROUND: Over the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. The purpose of this study was to compare the lower extremity mechanics of Achilles tendon ruptured runners with healthy controls. METHODS: The participants with a past history of an Achilles tendon repair ( = 11) and healthy control ( = 11) subgroups were matched on sex, age, type of regular physical activity, mass, height, footfall pattern and lateral dominancy. Running kinetics and kinematics of the ankle, knee and hip were recorded using a high-speed motion capture system interfaced with a force platform. Achilles tendon length was measured using ultrasonography. Main outcome measures were lower extremity joint angles and moments during stance phase of running and Achilles tendon lengths. RESULTS: Athletes from Achilles tendon group had an affected gastro-soleus complex. Athletes with history of Achilles tendon rupture had reduced ankle range of motion during second half of the stance phase of running (Δ7.6°), an overextended knee during initial contact (Δ5.2°) and increased affected knee range of motion (Δ4.4°) during the first half of stance phase on their affected limb compared to the healthy control group. There was a 22% increase in the maximal hip joint moment on contralateral side of the Achilles tendon group compared to the healthy controls. CONCLUSION: These results suggest a compensation mechanism, relatively extended knee at initial ground contact against the deficit in the muscle-tendon complex of the triceps surae. Overextension during sporting activities may place the knee at risk for further injury. Avoidance of AT lengthening and plantarflexion strength deficit after surgery and during rehabilitation might help to manage AT rupture since these factors may be responsible for altered running kinematics.
背景:在过去三十年中,运动员人群中跟腱断裂的发生率急剧上升。本研究的目的是比较跟腱断裂的跑步者与健康对照组的下肢力学情况。 方法:有跟腱修复病史的参与者(n = 11)和健康对照组(n = 11)在性别、年龄、常规体育活动类型、体重、身高、步幅模式和左右侧优势方面进行匹配。使用与测力平台相连的高速运动捕捉系统记录踝关节、膝关节和髋关节的跑步动力学和运动学数据。采用超声测量跟腱长度。主要观察指标为跑步支撑期的下肢关节角度和力矩以及跟腱长度。 结果:跟腱组的运动员存在患侧小腿三头肌复合体功能障碍。与健康对照组相比,有跟腱断裂病史的运动员在跑步支撑期后半段患侧踝关节活动范围减小(7.6°),初始接触时膝关节过度伸展(5.2°),支撑期前半段患侧膝关节活动范围增加(4.4°)。跟腱组对侧髋关节最大力矩比健康对照组增加了22%。 结论:这些结果提示了一种代偿机制,即在初始触地时膝关节相对伸展以代偿小腿三头肌肌腱复合体的功能缺陷。体育活动中的过度伸展可能使膝关节面临进一步受伤的风险。避免术后及康复期间跟腱延长和跖屈力量不足可能有助于处理跟腱断裂,因为这些因素可能导致跑步运动学改变。
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