Goodwin Jonathan S, Creighton Robert A, Pietrosimone Brian G, Spang Jeffery T, Blackburn J Troy
J Sport Rehabil. 2019 May 1;28(4):354-359. doi: 10.1123/jsr.2017-0106. Epub 2018 Dec 12.
Orthotic devices such as medial unloader knee braces and lateral heel wedges may limit cartilage loading following trauma or surgical repair. However, little is known regarding their effects on gait biomechanics in young, healthy individuals who are at risk of cartilage injury during physical activity due to greater athletic exposure compared with older adults. Determine the effect of medial unloader braces and lateral heel wedges on lower-extremity kinematics and kinetics in healthy, young adults. Cross-sectional crossover design. Laboratory setting. Healthy, young adults who were recreationally active (30 min/d for 3 d/wk) between 18 and 35 years of age, who were free from orthopedic injury for at least 6 months, and with no history of lower-extremity orthopedic surgery. All subjects completed normal over ground walking with a medial unloader brace at 2 different tension settings and a lateral heel wedge for a total of 4 separate walking conditions. Frontal plane knee angle at heel strike, peak varus angle, peak internal knee valgus moment, and frontal plane angular impulse were compared across conditions. The medial unloader brace at 50% (-2.04° [3.53°]) and 100% (-1.80° [3.63°]) maximum load placed the knee in a significantly more valgus orientation at heel strike compared with the lateral heel wedge condition (-0.05° [2.85°]). However, this difference has minimal clinical relevance. Neither of the orthotic devices altered knee kinematics or kinetics relative to the control condition. Although effective in older adults and individuals with varus knee alignment, medial unloader braces and lateral heel wedges do not influence gait biomechanics in young, healthy individuals.
诸如内侧卸载式膝关节支具和外侧足跟楔形垫等矫形器械,可能会在创伤或手术修复后限制软骨负荷。然而,对于那些因比老年人更多地参与体育活动而有软骨损伤风险的年轻健康个体,这些器械对其步态生物力学的影响却知之甚少。确定内侧卸载式支具和外侧足跟楔形垫对健康年轻成年人下肢运动学和动力学的影响。横断面交叉设计。实验室环境。年龄在18至35岁之间、每周至少进行3次、每次30分钟休闲活动、至少6个月无骨科损伤且无下肢骨科手术史的健康年轻成年人。所有受试者在2种不同张力设置的内侧卸载式支具和外侧足跟楔形垫的情况下完成正常的地面行走,共4种不同的行走条件。比较各条件下足跟触地时的额状面膝关节角度、最大内翻角度、膝关节最大内翻力矩以及额状面角冲量。与外侧足跟楔形垫条件(-0.05°[2.85°])相比,内侧卸载式支具在50%(-2.04°[3.53°])和100%(-1.80°[3.63°])最大负荷时,足跟触地时膝关节处于明显更外翻的位置。然而,这种差异的临床相关性极小。相对于对照条件,两种矫形器械均未改变膝关节的运动学或动力学。尽管内侧卸载式支具和外侧足跟楔形垫对老年人和膝关节内翻的个体有效,但它们并不影响年轻健康个体的步态生物力学。