Jang Jaeho, Wikstrom Erik A
MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, USA.
MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, USA.
Gait Posture. 2023 Feb;100:1-7. doi: 10.1016/j.gaitpost.2022.11.012. Epub 2022 Nov 25.
Individuals with chronic ankle instability (CAI) exhibit aberrant gait biomechanics relative to uninjured controls. Altered gait biomechanics likely contribute aberrant joint loading and subsequent early onset ankle joint degeneration. Joint (i.e. cartilage) loading cannot be directly measured without invasive procedures but can be estimated via joint contact forces (JCF) generated from musculoskeletal modeling. However, no investigation has quantified JCF in those with CAI during walking despite the link between ligamentous injury and ankle post-traumatic ankle osteoarthritis.
Do patients with CAI exhibit altered ankle compressive and shear JCF profiles during the stance phase of walking compared to those without CAI?
Ten individuals with CAI and 10 individuals without a history of ankle sprain completed a gait assessment at their self-selected speed on an instrumented treadmill. Musculoskeletal modeling was applied to estimate ankle JCF variables within a generic model. Variables included the peak, impulse, and loading rates for compressive, anteroposterior shear, and mediolateral shear JCF.
Those with CAI had significantly different JCF forces, relative to uninjured controls, in all directions. More specifically, lower compressive peak and impulse values were noted while higher anteroposterior shearing forces (1 st peak, impulse, loading late) were observed in those with CAI. Those with CAI also demonstrated higher mediolateral shearing forces (1 st peak and impulse).
Our finding suggests that those with CAI exhibit different ankle joint loading patterns than uninjured controls. Directionality of the identified differences depends on the axis of movement.
与未受伤的对照组相比，慢性踝关节不稳（CAI）患者表现出异常的步态生物力学。步态生物力学的改变可能导致异常的关节负荷以及随后的踝关节早期退变。在不进行侵入性操作的情况下，关节（即软骨）负荷无法直接测量，但可以通过肌肉骨骼模型产生的关节接触力（JCF）进行估计。然而，尽管韧带损伤与创伤后踝关节骨关节炎之间存在联系，但尚无研究对CAI患者行走过程中的JCF进行量化。
与无CAI的患者相比，CAI患者在步行站立期的踝关节压缩和剪切JCF分布是否存在改变？
10名CAI患者和10名无踝关节扭伤病史的个体在装有仪器的跑步机上以自我选择的速度完成了步态评估。应用肌肉骨骼模型在通用模型中估计踝关节JCF变量。变量包括压缩、前后剪切和内外侧剪切JCF的峰值、冲量和负荷率。
与未受伤的对照组相比，CAI患者在各个方向上的JCF力均有显著差异。更具体地说，CAI患者的压缩峰值和冲量值较低，而前后剪切力较高（第1个峰值、冲量、后期负荷）。CAI患者的内外侧剪切力也较高（第1个峰值和冲量）。
我们的研究结果表明，CAI患者与未受伤的对照组表现出不同的踝关节负荷模式。所确定差异的方向性取决于运动轴。
