Ménard Mathieu, Lacouture Patrick, Domalain Mathieu
Institut PPrime, CNRS - Université de Poitiers - ENSMA, UPR 3346, 11 bd Marie et Pierre Curie, BP 30179 - 86962 Futuroscope, France.
Int J Sports Phys Ther. 2020 Dec;15(6):958-966. doi: 10.26603/ijspt20200958.
Despite abundant literature, the treatment of iliotibial band syndrome (ITBS) in cyclists remains complicated as it lacks evidence-based recommendations.
The aim of this study was to develop a musculoskeletal modelling approach that investigates three potential biomechanical determinants of ITBS (strain, strain rate and compression force) and to use this approach to investigate the effect of saddle setback.
Cross-sectional.
An existing 3D lower-body musculoskeletal model was adapted to cycling and to the computation of three putative pathomechanisms responsible for ITBS: ITB strain, ITB strain rate, and compression force between ITB and the lateral femoral epicondyle (LFE). Lower limb kinematics recorded from ten well-trained healthy cyclists served as input data of the model. Cyclists pedalled at a steady state (90rpm and 200W) on an ergometer, and three different saddle setback conditions were tested. The theoretical combined influence of hip and knee joint angles on ITBS was investigated and analysed through the lens of individual pedalling technique.
ITB-LFE compression force was the only parameter significantly affected by saddle setback and supports the hypothesis that compression force is likely to be a determinant factor in ITBS etiology. Furthermore, results showed that ITB-LFE compression force increases in individuals whose pedalling technique exacerbates hip extension-adduction and/or knee extension-internal rotation.
This approach has the potential to be advantageously implemented as an additional tool to help diagnose/correct potentially harmful sport techniques and optimize equipment setup/design.
3b.
尽管有大量文献，但自行车运动员髂胫束综合征（ITBS）的治疗仍然复杂，因为缺乏基于证据的建议。
本研究的目的是开发一种肌肉骨骼建模方法，研究ITBS的三个潜在生物力学决定因素（应变、应变率和压缩力），并使用该方法研究鞍座后移的影响。
横断面研究。
对现有的三维下肢肌肉骨骼模型进行修改，以适应自行车运动，并计算导致ITBS的三种假定发病机制：髂胫束应变、髂胫束应变率以及髂胫束与股骨外侧髁（LFE）之间的压缩力。从10名训练有素的健康自行车运动员记录的下肢运动学数据作为模型的输入数据。自行车运动员在测力计上以稳定状态（90转/分钟和200瓦）蹬踏，并测试三种不同的鞍座后移条件。通过个体蹬踏技术的角度研究和分析髋关节和膝关节角度对ITBS的理论综合影响。
髂胫束-股骨外侧髁压缩力是唯一受鞍座后移显著影响的参数，支持压缩力可能是ITBS病因中的一个决定因素的假设。此外，结果表明，在蹬踏技术加剧髋关节伸展内收和/或膝关节伸展内旋的个体中，髂胫束-股骨外侧髁压缩力增加。
这种方法有可能作为一种辅助工具得到有益应用，以帮助诊断/纠正潜在有害的运动技术，并优化设备设置/设计。
3b。
