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髋关节相关腹股沟疼痛患者向前踏步时下的踝关节背屈和髋关节与骨盆运动学。

Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain.

出版信息

J Sport Rehabil. 2020 Dec 8;30(4):638-645. doi: 10.1123/jsr.2020-0140.

Abstract

CONTEXT

The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function.

OBJECTIVE

To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain.

DESIGN

Cross-sectional Setting: Academic medical center.

PATIENTS

A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated.

INTERVENTION

None.

MAIN OUTCOME MEASURES

Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations.

RESULTS

Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion.

CONCLUSIONS

Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

摘要

背景

作者假设,在与髋关节相关的腹股沟疼痛患者中,较小的踝关节背屈可能导致在单腿跳下时髋关节内收和对侧骨盆下降的代偿。踝关节背屈可能是一个可改变的因素,可以提高与髋关节相关的腹股沟疼痛患者的能力,减少功能任务中髋关节/骨盆的运动,并改善功能。

目的

确定与髋关节相关的腹股沟疼痛患者在单腿跳下时,较小的静态踝关节背屈角度是否与踝关节、髋关节和骨盆运动学的改变有关。

设计

横断面研究;学术医疗中心。

患者

共 30 名与髋关节相关的腹股沟疼痛患者(男性 12 名,女性 18 名;28.7[5.3]岁)参与了本研究。

干预措施

无。

主要观察指标

通过数字测斜仪测量膝关节弯曲和伸展时的负重静态踝关节背屈;通过三维运动捕捉测量向前单腿跳下时的骨盆、髋关节和踝关节运动学。静态踝关节背屈和运动学通过二元相关进行比较。

结果

较小的静态踝关节背屈角度与膝关节弯曲和伸展时的静态踝关节背屈角度都与单腿跳下时较小的踝关节背屈角度有关。在整个样本中,膝关节弯曲时较小的静态踝关节背屈角度与单腿跳下时更大的前骨盆倾斜和更大的对侧骨盆下降有关。仅在那些不需要降低台阶以确保安全的患者中,膝关节弯曲和伸展时较小的静态踝关节背屈角度与更大的前骨盆倾斜、更大的对侧骨盆下降和更大的髋关节屈曲有关。

结论

在与髋关节相关的腹股沟疼痛患者中,较小的静态踝关节背屈角度与单腿跳下时较小的踝关节背屈运动以及骨盆和髋关节运动学的改变有关。需要进一步研究来评估治疗受限的踝关节背屈对与髋关节相关的腹股沟疼痛患者的运动质量和症状的影响。

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