Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue
Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue
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DOI：
10.1177/0363546507308934
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发表时间：
2008-03-01
影响因子：
4.8
通讯作者：
Iwasaki, Mark
中科院分区：
文献类型：
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作者：
Kernozek, Thomas W.;Torry, Michael R.;Iwasaki, Mark
背景：神经肌肉疲劳已被认为是男女前交叉韧带非接触性损伤机制的外在因素。目的：研究和描述跌落过程中神经肌肉疲劳引起的下肢运动学和运动学差异，比较年龄和技能匹配的男、女运动员之间的变化。方法：对14名女运动员和16名男运动员进行50 cm单腿落地时，用逆动力学方法估算其下肢屈伸和内翻的运动学和动力学。受试者进行着陆前疲劳和后疲劳，通过平行的下蹲运动(最多重复1次的60%)引起疲劳，直到失败。对选定的运动学和运动学变量进行了混合模型重复测量方差分析(疲劳*性别)。结果：神经肌肉疲劳导致男性和女性更多的髋关节屈曲(主效应疲劳，P=.012；主效应性别，P=.001)。男性在疲劳后表现出更大的膝关节峰值屈曲角；女性没有改变膝关节屈曲(疲劳*性别，P=.028)。男性表现出更大的膝关节峰值内翻角度，与疲劳无关(主效应性别，P=.039；主效应疲劳，P=.127；疲劳*性别，P=.153)；女性总体表现出更大的峰值外翻角度(主效应性别，P=.009)。疲劳(主效应疲劳，P=.127)或因性别疲劳(疲劳*性别，P=.091)而引起的不同反应没有变化。女性在疲劳后表现出更大的膝关节前剪切力(疲劳*性别，P=.010)。男性和女性都表现出较低的膝关节伸展瞬间(主效疲劳，P=.000；主效应性别，P=.927；疲劳*性别，P=.309)和外展时刻(主效疲劳，P=.014；主效疲劳，P=.670；疲劳*性别，P=.191)。结论：神经肌肉疲劳引起女性的显著改变，这可能表明非接触性前交叉韧带损伤机制。临床相关性：当前的非接触性前交叉韧带预防计划应包括疲劳成分，以帮助将神经肌肉疲劳对着陆机制的有害影响降至最低。
Background: Neuromuscular fatigue has been suggested as an extrinsic factor in the mechanism of noncontact anterior cruciate ligament injury in both genders. Purpose: To determine and describe the lower extremity kinematic and kinetic differences caused by neuromuscular fatigue during drop landings and compare changes between age- and skill-matched male and female athletes.Methods: Inverse dynamic solutions estimated lower extremity flexion-extension and varus-valgus kinematics and kinetics for 14 female and 16 male athletes performing a single-legged 50-cm drop landing. Subjects performed landings prefatigue and postfatigue with fatigue induced via a parallel squat exercise (60% of 1 repetition maximum) until failure. A mixed-model, repeated-measures analysis of variance (fatigue * gender) was performed on select kinematic and kinetic variables.Results: Neuromuscular fatigue caused men and women to land with more hip flexion (main effect fatigue, P = .012; main effect gender, P = .001). Men exhibited greater peak knee flexion angles postfatigue; women did not alter knee flexion (fatigue * gender, P = .028). Men exhibited larger peak knee varus angles irrespective of fatigue (main effect gender, P = .039; main effect fatigue, P = .127; fatigue * gender, P = .153); women demonstrated larger peak valgus angles overall (main effects gender, P = .009). There were no changes with fatigue (main effect fatigue, P = .127) or a different response due to fatigue with gender (fatigue * gender, P = .091). Women exhibited greater knee anterior shear force postfatigue (fatigue * gender, P = .010). Men and women exhibited lower knee extension moments (main effect fatigue, P = .000; main effect gender, P = .927; fatigue * gender, P = .309) and abduction moments (main effect fatigue, P = .014; main effect gender, P = .670; fatigue * gender, P = .191).Conclusion: Neuromuscular fatigue caused significant alterations in women that may be indicative of the noncontact anterior cruciate ligament injury mechanisms.Clinical Relevance: Current noncontact anterior cruciate ligament prevention programs should incorporate a fatigue component to help minimize the deleterious effects of neuromuscular fatigue on landing mechanics.