Lu Tung-Wu, Wu Kuan-Hsien, Kuo Mei-Ying, Li Jia-DA, Lu Hsuan-Yu, Hsu Horng-Chaung
Department of Biomedical Engineering, National Taiwan University, TAIWAN, R.O.C.
School of Physical Therapy, China Medical University, TAIWAN, R.O.C.
Med Sci Sports Exerc. 2025 Aug 1;57(8):1743-1754. doi: 10.1249/MSS.0000000000003713. Epub 2025 Mar 28.
Stationary cycling is essential in rehabilitation programs for various patient groups, such as knee osteoarthritis and cruciate ligament injuries and reconstruction. The study aimed to measure in vivo the 3D rigid-body and articular surface kinematics of the knee and the patellar tendon orientations during stationary cycling and isolated flexion-extension exercise in healthy young adults using a model-based tracking approach with dual-plane fluoroscopy.
Ten healthy left knees were imaged by computed tomography and magnetic resonance imaging to reconstruct subject-specific volumetric bone-cartilage models. The 3D rigid-body and articular surface kinematics and patellar tendon angles during stationary cycling and isolated knee flexion-extension exercise were measured in vivo using a dual-plane fluoroscopy with a voxel-based registration method, compared between tasks and between power and recovery phases.
Significant differences in the rigid-body and surface kinematics and patellar tendon orientations were found between the power and recovery phases and between the power phase and isolated knee extension. Compared with the recovery phase, the power phase showed significantly greater external rotations, adductions, and posterior translations for flexions greater than 45° ( P < 0.05) with significantly more posterior medial and lateral contact positions for flexion angles less than 45° ( P < 0.05) and more vertical patellar tendon orientations for flexion angles lesser than 60° ( P < 0.05).
The contact locations and loads on the posterior half of the tibial articular surface during the first half of the power phase indicate that stationary cycling as a daily and rehabilitative exercise is safe for people with anterior medial knee osteoarthritis.
对于各类患者群体，如膝关节骨关节炎、十字韧带损伤及重建患者，固定自行车运动在康复计划中至关重要。本研究旨在使用基于模型的双平面荧光透视跟踪方法，在健康年轻成年人进行固定自行车运动和孤立屈伸运动期间，对膝关节的三维刚体和关节表面运动学以及髌腱方向进行活体测量。
对十个健康的左膝进行计算机断层扫描和磁共振成像，以重建特定个体的体积性骨软骨模型。使用基于体素配准方法的双平面荧光透视在活体中测量固定自行车运动和孤立膝关节屈伸运动期间的三维刚体和关节表面运动学以及髌腱角度，比较不同任务之间以及动力阶段和恢复阶段之间的差异。
在动力阶段和恢复阶段之间以及动力阶段和孤立膝关节伸展之间，发现刚体和表面运动学以及髌腱方向存在显著差异。与恢复阶段相比，动力阶段在屈曲大于45°时显示出显著更大的外旋、内收和后移（P < 0.05），在屈曲角度小于45°时后内侧和外侧接触位置显著更多（P < 0.05），在屈曲角度小于60°时髌腱方向更垂直（P < 0.05）。
动力阶段前半程胫骨关节面后半部分的接触位置和负荷表明，固定自行车运动作为日常和康复运动，对于前内侧膝关节骨关节炎患者是安全的。
