Reduced step length reduces knee joint contact forces during running following anterior cruciate ligament reconstruction but does not alter inter-limb asymmetry
Reduced step length reduces knee joint contact forces during running following anterior cruciate ligament reconstruction but does not alter inter-limb asymmetry
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DOI：
10.1016/j.clinbiomech.2017.02.004
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发表时间：
2017-03-01
影响因子：
1.8
通讯作者：
Willson, John D.
中科院分区：
文献类型：
--
作者：
Bowersock, Collin D.;Willy, Richard W.;Willson, John D.
背景：前交叉韧带重建与早发性膝骨关节炎有关。跑步是手术后的典型活动，但膝关节接触力升高被认为会导致骨关节炎退行性过程。因此，在前十字韧带重建后，确定减少个体跑步过程中接触力的干预措施具有临床意义。本研究的主要目的是评估跑步时减少步长对有前十字韧带重建史的人的髌股关节和胫股关节接触力的影响。还检查了跑步过程中肢体间膝关节接触力的差异。方法：18名个体在单侧前交叉韧带重建后平均54.8个月时在3步长条件下跑步（优选，-5％，-10％）。使用单独的双因素方差分析，在步长条件和四肢之间评估双侧髌股、胫股和内侧胫股间室峰值力、负载率、冲量和每公里冲量。结果：减少步长 5% 会降低双侧髌股、胫股和内侧胫股间室峰值力、冲量和每公里冲量。步长减少 10% 进一步降低了峰值力和力脉冲，但没有进一步降低每公里的力脉冲。与对侧肢体相比，先前受伤肢体的胫股关节冲量、每公里冲量和髌股关节负荷率较低。 解读：对于有前交叉韧带重建史的人来说，短步长跑步是减少跑步时膝关节接触力的一种可行的临床干预措施。 (C) 2017 Elsevier Ltd. 保留所有权利。
Background: Anterior cruciate ligament reconstruction is associated with early onset knee osteoarthritis. Running is a typical activity following this surgery, but elevated knee joint contact forces are thought to contribute to osteoarthritis degenerative processes. It is therefore clinically relevant to identify interventions to reduce contact forces during running among individuals after anterior cruciate ligament reconstruction. The primary purpose of this study was to evaluate the effect of reducing step length during running on patellofemoral and tibiofemoral joint contact forces among people with a history of anterior cruciate ligament reconstruction. Inter limb knee joint contact force differences during running were also examined.Methods: 18 individuals at an average of 54.8 months after unilateral anterior cruciate ligament reconstruction ran in 3 step length conditions (preferred, -5%, -10%). Bilateral patellofemoral, tibiofemoral, and medial tibiofemoral compartment peak force, loading rate, impulse, and impulse per kilometer were evaluated between step length conditions and limbs using separate 2 factor analyses of variance.Findings: Reducing step length 5% decreased patellofemoral, tibiofemoral, and medial tibiofemoral compartment peak force, impulse, and impulse per kilometer bilaterally. A 10% step length reduction further decreased peak forces and force impulses, but did not further reduce force impulses per kilometer. Tibiofemoral joint impulse, impulse per kilometer, and patellofemoral joint loading rate were lower in the previously injured limb compared to the contralateral limb.Interpretation: Running with a shorter step length is a feasible clinical intervention to reduce knee joint contact forces during running among people with a history of anterior cruciate ligament reconstruction. (C) 2017 Elsevier Ltd. All rights reserved.