Evidence of Mechanical Load Redistribution at the Knee Joint in the Elderly when Ascending Stairs and Ramps
Evidence of Mechanical Load Redistribution at the Knee Joint in the Elderly when Ascending Stairs and Ramps
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DOI：
10.1007/s10439-008-9624-7
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发表时间：
2009-03-01
影响因子：
3.8
通讯作者：
Arampatzis, Adamantios
中科院分区：
文献类型：
--
作者：
Karamanidis, Kiros;Arampatzis, Adamantios
这项研究检测了一组老年人和年轻人在爬楼梯和坡道时，在所有三个方向上的下肢外部关节力矩。28名老年人和16名年轻人登上了专门建造的楼梯和坡道。运动捕捉系统和测力板被用来确定受试者的三维运动学和地面反作用力。腿的运动学和动力学计算是通过一个刚性的、三段式的三维腿模型进行的。与年轻人相比，老年人的背屈和膝关节屈曲力矩较小，而髋关节屈曲力矩较大，与运动条件无关。在其他两个平面上，老年人在膝关节和髋关节表现出更高的内收力矩，以及更高的膝关节内旋力矩。此外，在所检查的两种情况下，在站立阶段开始时，老年人小腿相对于大腿的位置更靠外。老年人膝关节较高的内收力矩和内旋力矩，结合横断面的运动学变化，说明老年人在膝关节的承重区重新分配了机械负荷。我们的结论是，膝关节负荷的重新分布可能增加了老年人发生膝骨性关节炎的危险因素。
This study examined the external joint moments at the lower extremity in all three directions in a group of older and younger adults when ascending stairs and ramps. Twenty-eight older and 16 younger adults ascended a purpose-built staircase and ramp. A motion capture system and a force plate were used to determine the subjects' 3D kinematics and ground reaction forces. Calculation of the leg kinematics and kinetics was done by means of a rigid, three-segment, 3D leg model. Older had lower dorsiflexion and knee flexion moments but higher hip flexion moments than the younger adults, independent of locomotion condition. Concerning the other two planes, older adults showed higher adduction moments at the knee and hip joint, and higher knee internal rotation moments. Furthermore, the elderly showed a more external position of the shank in relation to the thigh at the initiation of the stance phase for the two conditions examined. The higher adduction and internal rotation moments at the knee when combined with the kinematic changes in the transverse plane for the elderly give evidence that older adults redistribute the mechanical load within the load bearing regions of the knee. We concluded that the redistribution in knee joint loading may increase the risk factors for developing knee osteoarthritis in the elderly.