Trunk and Hip Biomechanics Influence Anterior Cruciate Loading Mechanisms in Physically Active Participants
Trunk and Hip Biomechanics Influence Anterior Cruciate Loading Mechanisms in Physically Active Participants
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DOI：
10.1177/0363546513496625
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发表时间：
2013-11-01
影响因子：
4.8
通讯作者：
Padua, Darin A.
中科院分区：
文献类型：
--
作者：
Frank, Barnett;Bell, David R.;Padua, Darin A.
背景资料：过度的躯干运动和腰盆髋关节复合体的神经肌肉控制（NMC）缺陷是前交叉韧带（ACL）损伤的危险因素。然而，在侧步切割任务期间躯干运动、腰盆髋复合体的NMC和三平面膝关节载荷之间的关系尚未被检查。目的：为了确定在侧步切割任务期间多平面躯干运动、腰盆髋复合体的NMC和三平面膝关节载荷与ACL损伤之间是否存在关联。研究设计：描述性实验室研究。方法：在侧步切割任务期间，使用光电摄像系统连接到测力板，对30名参与者（15名男性，15名女性）的髋关节和膝关节生物力学以及躯干运动进行了分析。躯干和下肢的生物力学计算的运动学和地面反作用力的数据在第一个50%的立场时间在切割任务。计算躯干和下肢生物力学之间的Pearson积矩相关系数。进行多元线性回归分析，以确定由躯干运动和髋关节力矩解释的三平面膝关节载荷的方差。（平均0.11 +/- 0.12 N.m/kg*m）与躯干远离站立肢体的横向平面旋转较少相关（平均20.25度± 4.42度; r =-0.46，P = 0.011）和更大的髋内收力矩（平均0.33 ± 0.25 N.m/kg*m; r = 0.83，P <0.05）。更大的膝关节内旋力矩（平均值，0.11 +/- 0.08 N.m/kg*m）与更大的躯干前屈相关（平均值，7.62 ° +/- 5.28 °; r = 0.42，P = 0.020）和更大的髋关节内旋力矩（平均值，0.15 +/- 0.16 Nm/kg*m; r = 0.59，P = .001）。躯干旋转和髋内收力矩解释了膝内翻力矩变异的81%（P <0.05）。躯干屈曲和髋关节内旋力矩解释48%（P < .05）膝关节外旋力矩的方差。结论：躯干向新运动方向的有限旋转位移和髋内收力矩与膝内翻力矩增加相关，而躯干屈曲位移和髋关节内旋力矩的联合增加与较高的膝关节内旋相关临床相关性：ACL损伤的预防干预应鼓励躯干向新的行进方向旋转，并限制躯干过度屈曲，同时调整额面和横面髋关节NMC。
Background: Excessive trunk motion and deficits in neuromuscular control (NMC) of the lumbopelvic hip complex are risk factors for anterior cruciate ligament (ACL) injury. However, the relationship between trunk motion, NMC of the lumbopelvic hip complex, and triplanar knee loads during a sidestep cutting task has not been examined.Purpose: To determine if there is an association between multiplanar trunk motion, NMC of the lumbopelvic hip complex, and triplanar knee loads with ACL injury during a sidestep cutting task.Study Design: Descriptive laboratory study.Methods: The hip and knee biomechanics and trunk motion of 30 participants (15 male, 15 female) were analyzed during a side-step cutting task using an optoelectric camera system interfaced to a force plate. Trunk and lower extremity biomechanics were calculated from the kinematic and ground-reaction force data during the first 50% of the stance time during the cutting task. Pearson product moment correlation coefficients were calculated between trunk and lower extremity biomechanics. Multiple linear regression analyses were carried out to determine the amount of variance in triplanar knee loading explained by trunk motion and hip moments.Results: A greater internal knee varus moment (mean, 0.11 +/- 0.12 N.m/kg*m) was associated with less transverse-plane trunk rotation away from the stance limb (mean, 20.25 degrees +/- 4.42 degrees; r = -0.46, P = .011) and a greater internal hip adduction moment (mean, 0.33 +/- 0.25 N.m/kg*m; r = 0.83, P < .05). A greater internal knee external rotation moment (mean, 0.11 +/- 0.08 N.m/kg*m) was associated with a greater forward trunk flexion (mean, 7.62 degrees +/- 5.28 degrees; r = 0.42, P = .020) and a greater hip internal rotation moment (mean, 0.15 +/- 0.16 Nm/kg*m; r = 0.59, P = .001). Trunk rotation and hip adduction moment explained 81% (P < .05) of the variance in knee varus moment. Trunk flexion and hip internal rotation moment explained 48% (P < .05) of the variance in knee external rotation moment.Conclusion: Limited trunk rotation displacement toward the new direction of travel and hip adduction moment are associated with an increased internal knee varus moment, while a combined increase in trunk flexion displacement and hip internal rotation moment is associated with a higher internal knee external rotation moment.Clinical Relevance: Prevention interventions for ACL injury should encourage trunk rotation toward the new direction of travel and limit excessive trunk flexion while adjusting frontal- and transverse-plane hip NMC.