Xu Yue, Mo Yizhang, Liu Chengxiao, Chen Haofan, Zhao Jianhao, Zhang Wanxia, Yu Yang, Li Yulin, Wang Lina, Yuan Yingge, Sun Zhongyue, Ni Guoxin, Song Bin
Department of Joint Surgery and Sports Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Sports Act Living. 2025 Jun 6;7:1593231. doi: 10.3389/fspor.2025.1593231. eCollection 2025.
BACKGROUND: Patients with chronic ankle instability (CAI) have demonstrated altered hip and knee movement strategies during walking and running, but these movement modalities do not involve changes in speed and direction, making it difficult to simulate the conditions of real sports, whereas side-cutting task can provide CAI patients with a more realistic athletic challenge. However, there is limited literature examining the kinematic and kinetic differences in the hip, knee, and ankle joints of CAI patients during the side-cutting task. OBJECTIVE: To assess differences in lower extremity joint kinematics and kinetics during the side-cutting task in individuals with and without CAI. DESIGN: Cross-sectional study. PARTICIPANTS: 48 males, 24 in each of the CAI group and healthy control group; 40 females, 20 in each of the CAI group and healthy control group. METHODS: Lower extremity three-dimensional kinematic and kinetics data were evaluated by using a three-dimensional motion analysis system during the initial contact (IC) and toe off (TO) while side-cutting. RESULTS: Compared with healthy controls, male patients with CAI exhibited greater hip flexion and external rotation angles, knee internal rotation angles, smaller knee flexion angles and ankle inversion angles, greater hip external rotation moments, and greater knee abduction moments; female patients with CAI exhibited smaller hip and knee flexion angles, greater hip external rotation angles, larger ankle inversion angles and internal rotation angles, smaller hip external rotation moments, and greater knee abduction moments. CONCLUSION: Our findings indicate that patients with CAI exhibit altered lower limb joint kinematics and kinetics during side-cutting task, with significant sex-specific differences. These movement pattern changes involve proximal joint compensation to stabilize the unstable distal ankle joint; however, these compensatory changes are not always favorable. The greater hip external rotation moment and greater knee internal rotation angle demonstrated by male CAI patients, the smaller hip flexion angle and greater ankle internal rotation angle demonstrated by female CAI patients, and the smaller knee flexion angle and greater knee abduction moment common to both sexes may impair the lower limb's ability to effectively absorb and dissipate ground reaction forces, potentially elevating the risk of lower extremity injuries.
背景:慢性踝关节不稳(CAI)患者在行走和跑步过程中已表现出髋部和膝部运动策略的改变,但这些运动方式不涉及速度和方向的变化,难以模拟真实运动的情况,而侧切任务能为CAI患者提供更现实的运动挑战。然而,关于CAI患者在侧切任务期间髋、膝和踝关节的运动学和动力学差异的文献有限。 目的:评估有和没有CAI的个体在侧切任务期间下肢关节运动学和动力学的差异。 设计:横断面研究。 参与者:48名男性,CAI组和健康对照组各24名;40名女性,CAI组和健康对照组各20名。 方法:在侧切过程中的初始接触(IC)和足趾离地(TO)时,使用三维运动分析系统评估下肢三维运动学和动力学数据。 结果:与健康对照组相比,男性CAI患者表现出更大的髋部屈曲和外旋角度、膝部内旋角度、更小的膝部屈曲角度和踝关节内翻角度、更大的髋部外旋力矩以及更大的膝部外展力矩;女性CAI患者表现出更小的髋部和膝部屈曲角度、更大的髋部外旋角度、更大的踝关节内翻角度和内旋角度、更小的髋部外旋力矩以及更大的膝部外展力矩。 结论:我们的研究结果表明,CAI患者在侧切任务期间表现出下肢关节运动学和动力学的改变,存在显著的性别差异。这些运动模式的变化涉及近端关节的代偿,以稳定不稳定的远端踝关节;然而,这些代偿性变化并不总是有利的。男性CAI患者表现出的更大的髋部外旋力矩和更大的膝部内旋角度、女性CAI患者表现出的更小的髋部屈曲角度和更大的踝关节内旋角度,以及两性共有的更小的膝部屈曲角度和更大的膝部外展力矩,可能会损害下肢有效吸收和消散地面反作用力的能力,潜在地增加下肢受伤的风险。
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