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髋关节撞击综合征患者的躯干、骨盆和髋关节生物力学:上台阶策略。

Trunk, pelvis and hip biomechanics in individuals with femoroacetabular impingement syndrome: Strategies for step ascent.

机构信息

Griffith University, Menzies Health Institute Queensland, School of Allied Health Sciences, Gold Coast, QLD, 4222, Australia; The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC, 3010, Australia.

The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC, 3010, Australia.

出版信息

Gait Posture. 2018 Mar;61:176-182. doi: 10.1016/j.gaitpost.2018.01.005. Epub 2018 Jan 11.

Abstract

BACKGROUND

Femoroacetabular impingment (FAI) syndrome is common among young active adults and a proposed risk factor for the future development of hip osteoarthritis. Pain is dominant and drives clinical decision-making. Evidence for altered hip joint function in this patient population is inconsistent, making the identification of treatment targets challenging. A broader assessment, considering adjacent body segments (i.e. pelvis, trunk) and individual movement strategies, may better inform treatment programs. This exploratory study aimed to compare trunk, pelvis, and hip biomechanics during step ascent between individuals with and without FAI syndrome.

METHODS

Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery, and 11 age-, and sex-comparable pain- and disease-free individuals, underwent three-dimensional motion analysis during a step ascent task. Trunk, pelvis and hip biomechanics were compared between groups.

RESULTS

Participants with FAI syndrome exhibited altered ipsilateral trunk lean and pelvic rise towards the symptomatic side during single-leg support compared to controls. Alterations were not uniformly adopted across all individuals with FAI syndrome; those who exhibited more pronounced alterations to frontal plane pelvis control tended to report pain during the task. There were minimal between-group differences for hip biomechanics.

CONCLUSION

Exploratory data suggest biomechanics at the trunk and pelvis during step ascent differ between individuals with and without FAI syndrome. Those with FAI syndrome implement a range of proximal strategies for task completion, some of which may have relevance for rehabilitation. Longitudinal investigations of larger cohorts are required to evaluate hypothesized clinical and structural consequences.

摘要

背景

股骨髋臼撞击症(FAI)在年轻活跃的成年人中很常见,是未来髋关节骨关节炎发展的一个潜在危险因素。疼痛是主要症状,主导着临床决策。在这一患者群体中,髋关节功能改变的证据并不一致,这使得治疗目标的确定具有挑战性。更广泛的评估,包括相邻的身体部位(即骨盆、躯干)和个体运动策略,可以为治疗方案提供更好的信息。本探索性研究旨在比较有和没有 FAI 综合征的个体在单腿站立上升阶段时躯干、骨盆和髋关节的生物力学。

方法

15 名患有症状性凸轮型或混合型(凸轮加钳夹)FAI 的患者被安排接受关节镜手术,11 名年龄和性别相匹配的无疼痛和无疾病的个体在单腿站立上升任务中接受了三维运动分析。比较两组之间的躯干、骨盆和髋关节生物力学。

结果

与对照组相比,患有 FAI 综合征的参与者在单腿支撑时,同侧躯干倾斜和骨盆向患侧上升。但并不是所有患有 FAI 综合征的个体都采用了相同的方式来改变;那些表现出更明显的骨盆矢状面控制改变的人在任务中往往会感到疼痛。髋关节生物力学方面两组之间几乎没有差异。

结论

探索性数据表明,在单腿站立上升阶段,有和没有 FAI 综合征的个体的躯干和骨盆的生物力学存在差异。患有 FAI 综合征的患者在完成任务时采用了一系列近端策略,其中一些可能与康复有关。需要对更大的队列进行纵向研究,以评估假设的临床和结构后果。

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