内侧半月板损伤引起的疼痛对步行运动模式的影响。

The impact of pain from medial meniscus injuries on walking movement patterns.

作者信息

Chen Yiyan, Wang Liyan, Fan Zhiying, Zhou Haibin, Lu Aming

机构信息

Department of Physical Education, Suzhou Vocational University, Suzhou, China.

Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Front Bioeng Biotechnol. 2025 Apr 22;13:1545521. doi: 10.3389/fbioe.2025.1545521. eCollection 2025.

DOI:10.3389/fbioe.2025.1545521

PMID:40330007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12052531/

Abstract

BACKGROUND

Existing literature provides inconclusive evidence regarding the impact of pain on movement patterns, especially in medial meniscus injuries. This study investigated how pain induced by medial meniscus injuries affects walking movement patterns, focusing on the biomechanical mechanisms. The goal was to develop targeted rehabilitation.

METHODS

Thirty control participants (15 male, 15 female), 23 individuals with medial meniscus injury but no pain (11 male, 12 female), and 51 individuals with medial meniscus injury and pain (24 male, 27 female) were recruited. Gait data was collected using eight inertial measurement units and a video camera. Pain characteristics were assessed using the Visual Analog Scale (VAS) score, Tampa Scale for Kinesiophobia (TSK), Pain Catastrophizing Scale, and pain duration score. Statistical analyses were conducted using a one-way ANOVA to compare movement patterns among the three groups. Bivariate correlation analyses were performed within the pain group to examine the relationship between pain characteristics and movement patterns. The was set at 0.05.

RESULTS

(1) ANOVA among the groups revealed significant differences ( < 0.05) in several parameters: a shorter swing phase, reduced hip and knee angles, increased variability index, increased calf-foot mean absolute relative phase (MARP) during the support phase, and decreased calf-foot MARP during the swing phase were associated with pain. (2) Within the pain group, pain in knee extension (PKE) was negatively correlated with hip and ankle angles, stride length, and thigh-calf MARP during the support phase ( < 0.05). The VAS exhibited a negative correlation with knee angle and stride length, and a positive correlation with shock attenuation ( < 0.05). The TSK showed a positive correlation with hip and knee angles, and calf-foot MARP during the swing phase, while it was negatively correlated with stride length ( < 0.05).

CONCLUSION

Medial meniscus injury-induced pain has several adverse effects, including prolonged walking swing periods, reduced angulation, and increased variability while positively influencing coordination and shock attenuation. Pain intensity, kinesiophobia, and pain freedom contribute to these changes. Therapists should focus on pain management and movement pattern retraining to develop personalized rehabilitation. The angle of the swing phase should be emphasized during retraining.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/showproj.html?proj=65961, identifier ChiCTR2000041087.

摘要

背景

现有文献关于疼痛对运动模式的影响提供了不确定的证据，尤其是在内侧半月板损伤方面。本研究调查了内侧半月板损伤引起的疼痛如何影响步行运动模式，重点关注生物力学机制。目的是制定有针对性的康复方案。

方法

招募了30名对照参与者（15名男性，15名女性）、23名内侧半月板损伤但无疼痛的个体（11名男性，12名女性）以及51名内侧半月板损伤且疼痛的个体（24名男性，27名女性）。使用八个惯性测量单元和一台摄像机收集步态数据。使用视觉模拟量表（VAS）评分、坦帕运动恐惧量表（TSK）、疼痛灾难化量表和疼痛持续时间评分来评估疼痛特征。采用单因素方差分析进行统计分析，以比较三组之间的运动模式。在疼痛组内进行双变量相关分析，以检查疼痛特征与运动模式之间的关系。设定α为0.05。

结果

（1）组间方差分析显示，在几个参数上存在显著差异（P<0.05）：摆动期较短、髋部和膝部角度减小、变异性指数增加、支撑期小腿-足部平均绝对相对相位（MARP）增加以及摆动期小腿-足部MARP减小与疼痛有关。（2）在疼痛组内，膝关节伸展疼痛（PKE）与支撑期的髋部和踝关节角度、步长以及大腿-小腿MARP呈负相关（P<0.05）。VAS与膝关节角度和步长呈负相关，与减震呈正相关（P<0.05）。TSK与摆动期的髋部和膝部角度以及小腿-足部MARP呈正相关，而与步长呈负相关（P<0.05）。