DeVita P, Lassiter T, Hortobagyi T, Torry M
Department of Exercise and Sport Science, East Carolina University, Greenville, NC 27858, USA.
Am J Sports Med. 1998 Nov-Dec;26(6):778-84. doi: 10.1177/03635465980260060701.
The purpose of this study was to compare lower extremity joint kinematics and kinetics during walking with and without a functional knee brace in patients with recent anterior cruciate ligament reconstructions. Seven volunteers walked at 1.26 m/s with and without one of two functional knee braces 3 weeks after surgery. Eleven uninjured subjects were also tested as a control group. Video and ground-reaction data were collected and combined with inverse dynamics to estimate the joint positions, moments, and powers during the stance phase. Patients with ligament reconstructions were more erect with the brace, using 19% less knee flexion compared with walking without the brace. Areas under the internal extensor moment curve (angular impulse) and power curve (work) at the hip increased 40% and 44%, respectively, while walking with the brace. Extensor angular impulse decreased 41% at the knee while using the brace, and plantar flexor angular impulse and work increased 21% and 30%, respectively, at the ankle. While walking with the brace, the patients still had different kinematics, moments, and powers than the control subjects. The reduced extensor moment at the knee in the braced condition indicated that the load on the recently reconstructed ligament was reduced and that the brace protected the ligament during the stance phase of walking. We concluded that functional knee braces may be one means of developing neuromuscular adaptations during gait after anterior cruciate ligament reconstruction surgery.
本研究的目的是比较近期接受前交叉韧带重建手术的患者在佩戴和不佩戴功能性膝关节支具行走时的下肢关节运动学和动力学。七名志愿者在术后3周分别佩戴两种功能性膝关节支具之一和不佩戴支具以1.26米/秒的速度行走。还测试了11名未受伤的受试者作为对照组。收集视频和地面反作用力数据，并结合逆动力学来估计站立期的关节位置、力矩和功率。韧带重建患者佩戴支具时身体更挺直，与不佩戴支具行走相比，膝关节屈曲减少19%。佩戴支具行走时，髋关节内伸肌力矩曲线下面积（角冲量）和功率曲线下面积（功）分别增加40%和44%。佩戴支具时，膝关节伸肌角冲量减少41%，踝关节跖屈肌角冲量和功分别增加21%和30%。佩戴支具行走时，患者的运动学、力矩和功率仍与对照组不同。支具状态下膝关节伸肌力矩降低表明，近期重建韧带所承受的负荷减少，且支具在行走站立期保护了韧带。我们得出结论，功能性膝关节支具可能是前交叉韧带重建手术后步态中发展神经肌肉适应性的一种手段。
