Rudolph K S, Eastlack M E, Axe M J, Snyder-Mackler L
Department of Physical Therapy, University of Delaware, Newark 19716, USA.
J Electromyogr Kinesiol. 1998 Dec;8(6):349-62. doi: 10.1016/s1050-6411(97)00042-4.
The purpose of this study was to describe kinematic and kinetic differences between a group of ACL deficient subjects who were grouped according to functional ability. Sixteen patients with complete ACL rupture were studied; eight subjects had instability with activities of daily living (non-copers) and eight subjects had returned to all pre-injury activity without limitation (copers). Three-dimensional joint kinematics and kinetics were collected from the knee and ankle during walking, jogging and going up and over a step. Results showed that both groups mitigated the force with which they contacted the floor but non-copers consistently demonstrated less knee flexion in the involved limb. The copers used joint kinematics similar to those of their uninvolved knees and similar to knee motions reported in uninjured subjects. The reduced knee motion in the involved knee of the non-copers did not correlate directly with quadriceps femoris muscle weakness. The data suggest that the non-copers utilize a stabilization strategy which stiffens the knee joint which not only is unsuccessful but may lead to excessive joint contact forces which have the potential to damage articular structures. The copers use a strategy which permits normal knee kinematics and bodes well for joint integrity.
本研究的目的是描述一组根据功能能力分组的前交叉韧带（ACL）损伤受试者之间的运动学和动力学差异。对16例ACL完全断裂的患者进行了研究；8名受试者在日常生活活动中存在不稳定（非应对者），8名受试者已恢复到受伤前的所有活动且无限制（应对者）。在步行、慢跑以及上、下台阶过程中，收集了膝关节和踝关节的三维关节运动学和动力学数据。结果显示，两组均减轻了与地面接触的力，但非应对者受累肢体的膝关节屈曲始终较少。应对者使用的关节运动学与未受累膝关节相似，也与未受伤受试者报告的膝关节运动相似。非应对者受累膝关节运动减少与股四头肌无力无直接关联。数据表明，非应对者采用了一种使膝关节僵硬的稳定策略，这不仅不成功，还可能导致关节接触力过大，有可能损害关节结构。应对者采用的策略能使膝关节运动正常，对关节完整性有良好的预示作用。
