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负荷调节在踏上任务期间会影响小儿下肢关节力矩。

Load modulation affects pediatric lower limb joint moments during a step-up task.

作者信息

Goyal Vatsala, Gordon Keith E, Sukal-Moulton Theresa

出版信息

medRxiv. 2023 Oct 22:2023.10.20.23296774. doi: 10.1101/2023.10.20.23296774.

Abstract

Performance in a single step has been suggested to be sensitive measure of movement quality in pediatric clinical populations. Although there is less information available in children with typical development, researchers have postulated the importance of analyzing the effect of body weight modulation on the initiation of stair ascent, especially during single limb stance where upright stability is most critical. The purpose of this study was to investigate the effect of load modulation from -20% to +15% of body weight on typical pediatric lower limb joint moments during a step-up task. Fourteen participants between 5-21 years with no known history of neurological or musculoskeletal concerns were recruited to perform multiple step-up trials. Peak extensor support and hip abduction moments were identified during the push-off and pull-up stance phases. Linear regressions were used to determine the relationship between peak moments and load. Mixed effects models were used to estimate the effect of load on hip, knee, and ankle percent contributions to peak support moments. There was a positive linear relationship between peak support moments and load in both stance phases, where these moments scaled with load. There was no relationship between peak hip abduction moments and load. While the ankle and knee were the primary contributors to the support moments, the hip contributed more than expected in the pull-up phase. Clinicians can use these results to contextualize movement differences in pediatric clinical populations including cerebral palsy and highlight potential target areas for rehabilitation for populations such as adolescent athletes.

摘要

单步表现被认为是儿科临床人群运动质量的敏感指标。尽管关于发育正常儿童的相关信息较少,但研究人员推测分析体重调节对登梯起始的影响具有重要意义,尤其是在单腿站立阶段,此时直立稳定性最为关键。本研究的目的是调查在踏上台阶任务中,体重在 -20% 至 +15% 范围内调节时,对典型儿科下肢关节力矩的影响。招募了 14 名年龄在 5 - 21 岁之间、无已知神经或肌肉骨骼问题病史的参与者,进行多次踏上台阶试验。在蹬离和上拉站立阶段确定了峰值伸肌支撑力矩和髋关节外展力矩。使用线性回归来确定峰值力矩与负荷之间的关系。使用混合效应模型来估计负荷对髋关节、膝关节和踝关节对峰值支撑力矩贡献百分比的影响。在两个站立阶段,峰值支撑力矩与负荷之间均呈正线性关系,且这些力矩随负荷变化。峰值髋关节外展力矩与负荷之间无相关性。虽然踝关节和膝关节是支撑力矩的主要贡献者,但在向上拉起阶段,髋关节的贡献超过预期。临床医生可以利用这些结果来解释包括脑瘫在内的儿科临床人群的运动差异,并突出青少年运动员等人群潜在的康复目标区域。

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引用本文的文献

1
Children with bilateral cerebral palsy use their hip joint to complete a step-up task.
Front Hum Neurosci. 2024 Feb 20;18:1343457. doi: 10.3389/fnhum.2024.1343457. eCollection 2024.

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