Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Braz J Phys Ther. 2022 May-Jun;26(3):100414. doi: 10.1016/j.bjpt.2022.100414. Epub 2022 Apr 14.
Alterations of frontal plane patellar alignment could be related to lower limb disorders. Clinical assessment must be able to identify the influence of non-local factors in patellar alignment.
To identify the influence of lower limb torque, range of motion (ROM), and foot alignment on patellar rotation in healthy athletes.
This cross-sectional study was performed with 232 healthy basketball and volleyball elite athletes. Participants were assessed in preseason for: patellar medial and lateral rotation (Arno angle), passive hip internal rotation (IR) ROM, iliotibial band flexibility, hip abductors and external rotators (ER) torque, shank-forefoot alignment (SFA), and ankle dorsiflexion ROM. Hierarchical multiple linear regression was performed to identify if these variables and sex, age, and body mass could be associated with patellar rotation in a standing position.
Hip ER isometric torque explained a small part (10%) of the variance of the Arno angle in healthy athletes (R² change=0.10; unstandardized ß=11.74 (95% CI 6.82, 16.65); Standardized Coefficient Beta=0.32) and sex explained 2% of its variance (R² change=0.02; unstandardized ß= 2.42 (95% CI 0.32, 4.52); Standardized Coefficient Beta=0.15). After controlling for sex, hip ER torque explained 9% of Arno angle variance (R² change=0.09; unstandardized ß= 11.09 (95% CI 6.43, 15.76; Standardized Coefficient Beta=0.31). The other variables were not associated with patellar rotation.
Hip ER torque may influence patellar rotation in different directions (medial or lateral rotation). Possible mechanisms that explain the contribution of higher and lower hip ER torque in lateral and medial patellar rotation, respectively, are discussed.
髌股关节面排列的改变可能与下肢疾病有关。临床评估必须能够识别髌股排列受非局部因素的影响。
确定健康运动员的下肢力矩、运动范围（ROM）和足排列对髌股旋转的影响。
本横断面研究纳入 232 名健康篮球和排球精英运动员。在赛季前对参与者进行评估，包括髌内侧和外侧旋转（Arno 角）、被动髋关节内旋（IR）ROM、髂胫束柔韧性、髋关节外展肌和外旋肌（ER）力矩、小腿-前足排列（SFA）和踝关节背屈 ROM。进行分层多元线性回归，以确定这些变量以及性别、年龄和体重是否与站立位髌股旋转有关。
髋关节 ER 等长力矩解释了健康运动员 Arno 角变异的一小部分（10%）（R² 变化=0.10；未标准化 ß=11.74（95%CI 6.82, 16.65）；标准化系数 Beta=0.32），性别解释了其变异的 2%（R² 变化=0.02；未标准化 ß=2.42（95%CI 0.32, 4.52）；标准化系数 Beta=0.15）。控制性别后，髋关节 ER 力矩解释了 Arno 角变异的 9%（R² 变化=0.09；未标准化 ß=11.09（95%CI 6.43, 15.76）；标准化系数 Beta=0.31）。其他变量与髌股旋转无关。
髋关节 ER 力矩可能会以不同的方向影响髌股旋转（内侧或外侧旋转）。分别讨论了较高和较低髋关节 ER 力矩在髌股外侧和内侧旋转中的贡献的可能机制。
