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超重和肥胖对下肢行走特征的影响:从关节运动学到肌肉激活。

Effects of overweight and obesity on lower limb walking characteristics from joint kinematics to muscle activations.

机构信息

Biomedical and Instrumentation Engineering Program, Abdullah Al Salem University, Khalidiya, Kuwait; Department of Physical Medicine and Rehabilitation, Northwestern University, 345 East Superior Street, Chicago, IL 60611, USA.

Department of Mechanical Engineering, Australian University, P.O. Box 1411, East Mushrif, Kuwait.

出版信息

Gait Posture. 2024 Sep;113:337-344. doi: 10.1016/j.gaitpost.2024.06.024. Epub 2024 Jun 28.

Abstract

BACKGROUND

Obesity is a crucial factor that increases the risk of initiating and advancing knee osteoarthritis. However, it remains unclear how obesity directly impacts the biomechanical experience of the lower limb joints, potentially triggering or exacerbating joint degeneration. This study investigated the interactive effects of BMI augmentation on lower limb kinematics, kinetics, and muscle activations during walking.

METHODOLOGY

A group of 60 participants underwent a three-dimensional gait analysis. These individuals were categorized into three groups based on their body mass index (BMI): those with a BMI below 25 were classified as having a healthy weight, those with a BMI between 25 and 30 were categorized as overweight, and those with a BMI exceeding 30 were considered obese. This study analyzed the gait of 60 participants categorized by BMI. During walking trials, they recorded ground reaction forces electromyography of leg muscles like the gastrocnemii, hamstrings, and quadriceps. Lower limb joint angles and net moments were also calculated. Statistical mapping identified variations in kinematic, kinetic, and muscle activation patterns across the stance phase between BMI groups.

RESULTS

The results displayed distinct biomechanical patterns in obese individuals. Notably, there was a significant increase in flexion observed in the hip and knee joints (P < 0.001) during the initial stance phase and an increase in hip and knee adduction angles and moments throughout the entire stance phase (P < 0.001). Additionally, muscle activations underwent significant changes (P < 0.01), with a positive correlation noted with the BMI factor. This correlation was most pronounced during the early stance phase for the quadriceps and hamstring muscles and the late stance phase for the gastrocnemius.

CONCLUSION

These findings represent a comprehensive picture that contributes to understanding how excess weight and obesity influence joint biomechanics, highlighting the associated risk of joint osteoarthritis.

摘要

背景

肥胖是一个关键因素,它会增加引发和加重膝骨关节炎的风险。然而,目前尚不清楚肥胖如何直接影响下肢关节的生物力学体验,从而潜在地引发或加剧关节退化。本研究调查了 BMI 增加对步行时下肢运动学、动力学和肌肉激活的交互影响。

方法

一组 60 名参与者接受了三维步态分析。这些人根据体重指数(BMI)分为三组:BMI 低于 25 的人被归类为健康体重,BMI 在 25 到 30 之间的人被归类为超重,BMI 超过 30 的人被归类为肥胖。本研究分析了按 BMI 分类的 60 名参与者的步态。在步行试验中,他们记录了地面反作用力和腿部肌肉(如比目鱼肌、股四头肌和腘绳肌)的肌电图。还计算了下肢关节角度和净力矩。统计映射确定了 BMI 组之间在支撑相期间运动学、动力学和肌肉激活模式的变化。

结果

结果显示肥胖个体存在明显的生物力学模式。值得注意的是,在初始支撑相期间,髋关节和膝关节的屈曲明显增加(P < 0.001),整个支撑相期间髋关节和膝关节内收角度和力矩增加(P < 0.001)。此外,肌肉激活发生了显著变化(P < 0.01),与 BMI 因素呈正相关。这种相关性在股四头肌和腘绳肌的早期支撑相和比目鱼肌的晚期支撑相最为明显。

结论

这些发现提供了一个全面的图景,有助于理解超重和肥胖如何影响关节生物力学,并强调了与关节骨关节炎相关的风险。

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