Lange G W, Hintermeister R A, Schlegel T, Dillman C J, Steadman J R
Rehabilitation and Human Performance Laboratory, Steadman Hawkins Sports Medicine Foundation, Vail, CO 81657, USA.
J Orthop Sports Phys Ther. 1996 May;23(5):294-301. doi: 10.2519/jospt.1996.23.5.294.
Muscle activity, joints, angles, and heart rate during uphill walking were compared for application in knee rehabilitation. The objectives of this study were to quantify muscle activation levels at different treadmill grades and to determine the grade(s) at which knee range of motion would not further compromise the joint. Average and peak electromyographic activity of the quadriceps (vastus medialis oblique and vastus lateralis) and hamstrings (biceps femoris and medial hamstrings (semimembranosus/semitendinosus)] was recorded during walking at 0, 12, and 24% grade. Six subjects (age = 28.5 +/- 3.7 years, stature = 1.79 +/- .05 m, and mass = 74.7 +/- 7.9 kg) walked at self-selected speeds at each grade while ankle, knee and hip angles, heart rate, and electromyographic activity (surface electrodes) were recorded. Maximum voluntary contractions provided a relative reference for the electromyographic activity during walking. Average and peak electromyographic activity increased significantly across grades for the vastus medialis oblique (125 and 154%), vastus lateralis (109 and 139%), and biceps femoris (53 and 46%), but remained similar for the medial hamstrings. Maximum knee flexion at heel strike increased significantly with grade. Despite decreased self-selected speeds with increasing grade, there were significant increases in heart rate across grades. The results of this study provide a basic understanding of the quadriceps and hamstrings activity levels, lower extremity joint range of motion, and cardiovascular requirements of graded treadmill walking in normal subjects. The results also suggest that a grade just greater than 12% may be most beneficial for knee rehabilitation to minimize patellofemoral discomfort or potential strain on the anterior cruciate ligament. The benefits achieved through this functional activity encourage its implementation in rehabilitation and provide a basis for comparison with injured patients.
为了将其应用于膝关节康复，对上坡行走过程中的肌肉活动、关节、角度和心率进行了比较。本研究的目的是量化不同跑步机坡度下的肌肉激活水平，并确定不会进一步损害关节的坡度。在0%、12%和24%的坡度行走过程中，记录了股四头肌（股内侧斜肌和股外侧肌）和腘绳肌（股二头肌和内侧腘绳肌（半膜肌/半腱肌））的平均和峰值肌电图活动。六名受试者（年龄=28.5±3.7岁，身高=1.79±0.05米，体重=74.7±7.9千克）在每个坡度以自选速度行走，同时记录踝关节、膝关节和髋关节角度、心率和肌电图活动（表面电极）。最大自主收缩为行走过程中的肌电图活动提供了相对参考。股内侧斜肌（125%和154%）、股外侧肌（109%和139%）和股二头肌（53%和46%）的平均和峰值肌电图活动在各坡度间显著增加，但内侧腘绳肌的活动保持相似。足跟触地时的最大膝关节屈曲角度随坡度显著增加。尽管随着坡度增加自选速度降低，但各坡度间心率仍显著增加。本研究结果为正常受试者分级跑步机行走时股四头肌和腘绳肌的活动水平、下肢关节活动范围和心血管需求提供了基本认识。结果还表明，略高于12%的坡度可能对膝关节康复最有益，可将髌股关节不适或前交叉韧带潜在拉伤降至最低。通过这种功能活动获得的益处鼓励在康复中实施，并为与受伤患者进行比较提供了基础。
