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增加的踝关节蹬离动作改变了额状面的髋关节和膝关节力学。

Increased ankle pushoff alters frontal-plane hip and knee mechanics.

作者信息

Kratzer Avery L, Rao Ria P, Chang Alison H, Khuu Anne, Araújo Vanessa Lara de, Santos Thiago Ribeiro Teles, Lewis Cara L

机构信息

Department of Physical Therapy, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA.

Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

J Biomech. 2025 Apr;183:112623. doi: 10.1016/j.jbiomech.2025.112623. Epub 2025 Mar 8.

Abstract

In a simple model of bipedal walking, both a muscle moment at the hip and an impulsive push generated through ankle plantarflexion power gait. There is a biomechanical tradeoff between ankle and hip moments in the sagittal plane. Although ankle pushoff is primarily sagittal, its impact on frontal-plane mechanics, which are related to hip and knee injury risk, remains underexplored. This study aimed to investigate how increased ankle pushoff influences frontal-plane hip and knee moments during level walking. Understanding these effects could guide treatments for individuals with hip or knee symptoms linked to frontal-plane mechanics. Thirty-seven healthy adults walked on an instrumented treadmill under two conditions: Habitual (typical gait) and Push (increased ankle pushoff). Kinematic and kinetic data were collected and normalized for gait cycle and body weight. Statistical parametric mapping and peak value analysis were used to compare differences in internal joint moments and angles between conditions. Increased pushoff was confirmed by greater ankle plantarflexion moments and angular impulse in the Push condition. At the hip, increased pushoff resulted in a greater abduction moment early in stance and a reduced abduction moment and adduction angle late in stance. At the knee, increased pushoff led to a greater abduction moment late in stance. These findings suggest that increasing ankle pushoff during walking has significant effects on hip and knee frontal-plane biomechanics, which may not be beneficial for individuals with conditions influenced by hip and knee abduction moments.

摘要

在一个简单的双足行走模型中,髋关节处的肌肉力矩和通过踝关节跖屈力量步态产生的冲动推力都存在。在矢状面内,踝关节和髋关节力矩之间存在生物力学权衡。尽管踝关节蹬地主要发生在矢状面,但它对与髋关节和膝关节损伤风险相关的额面力学的影响仍未得到充分研究。本研究旨在探讨增加踝关节蹬地如何影响水平行走时额面的髋关节和膝关节力矩。了解这些影响可为与额面力学相关的髋部或膝部症状患者的治疗提供指导。37名健康成年人在两种条件下在装有仪器的跑步机上行走:习惯状态(典型步态)和蹬地状态(增加踝关节蹬地)。收集运动学和动力学数据,并针对步态周期和体重进行归一化处理。使用统计参数映射和峰值分析来比较两种状态下关节内力矩和角度的差异。在蹬地状态下,踝关节跖屈力矩和角冲量更大,证实了蹬地增加。在髋关节处,蹬地增加导致站立初期外展力矩增大,站立后期外展力矩减小且内收角度减小。在膝关节处,蹬地增加导致站立后期外展力矩增大。这些发现表明,行走过程中增加踝关节蹬地对髋关节和膝关节额面生物力学有显著影响,这可能对受髋关节和膝关节外展力矩影响的个体不利。

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