The influence of induced gait asymmetry on joint reaction forces.

The influence of induced gait asymmetry on joint reaction forces.
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诱发步态不对称对关节反作用力的影响。

DOI:
10.1016/j.jbiomech.2023.111581
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发表时间:
2023
影响因子:
2.4
通讯作者:
Saul,KatherineR
Saul,KatherineR
中科院分区:
工程技术3区
文献类型:
--
作者:
McCain,EmilyM;Dalman,MorganJ;Berno,MatthewE;Libera,TheresaL;Lewek,MichaelD;Sawicki,GregoryS;Saul,KatherineR

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慢性损伤或疾病引起的关节损伤导致不对称步态偏差,可能导致与疼痛和骨关节炎相关的关节负荷变化。了解步态偏差对关节反作用力(JRF)的影响具有挑战性,因为同时存在神经和/或解剖学变化,并且因为测量JRF需要医学侵入性仪器植入物。相反,我们研究了关节运动限制和诱导的不对称性对JRF的影响,通过模拟8名未受损的参与者使用支架行走以单侧和双侧限制踝关节、膝关节和踝关节+膝关节同时运动的数据。将个性化模型、计算的运动学和地面反作用力(GRF)输入到计算的肌肉控制工具中,以确定下肢JRF和由肌电图驱动的时间约束指导的模拟肌肉激活。单侧膝关节限制增加GRF峰值和负荷率同侧,但峰值降低对侧相比,步行无关节限制。与单侧限制条件下的对侧肢体相比,双侧限制条件下的GRF峰值和负荷率增加。尽管GRF发生了变化,但由于负荷反应期间肌肉力量减少,JRF相对不变。因此,虽然关节限制导致肢体负荷增加,但肌肉力量的减少抵消了肢体负荷的变化,使得JRF相对不变。
Chronic injury- or disease-induced joint impairments result in asymmetric gait deviations that may precipitate changes in joint loading associated with pain and osteoarthritis. Understanding the impact of gait deviations on joint reaction forces (JRFs) is challenging because of concurrent neurological and/or anatomical changes and because measuring JRFs requires medically invasive instrumented implants. Instead, we investigated the impact of joint motion limitations and induced asymmetry on JRFs by simulating data recorded as 8 unimpaired participants walked with bracing to unilaterally and bilaterally restrict ankle, knee, and simultaneous ankle + knee motion. Personalized models, calculated kinematics, and ground reaction forces (GRFs) were input into a computed muscle control tool to determine lower limb JRFs and simulated muscle activations guided by electromyography-driven timing constraints. Unilateral knee restriction increased GRF peak and loading rate ipsilaterally but peak values decreased contralaterally when compared to walking without joint restriction. GRF peak and loading rate increased with bilateral restriction compared to the contralateral limb of unilaterally restricted conditions. Despite changes in GRFs, JRFs were relatively unchanged due to reduced muscle forces during loading response. Thus, while joint restriction results in increased limb loading, reductions in muscle forces counteract changes in limb loading such that JRFs were relatively unchanged.
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DOI: --
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