Stair climbing results in more challenging patellofemoral contact mechanics and kinematics than walking at early knee flexion under physiological-like quadriceps loading
Stair climbing results in more challenging patellofemoral contact mechanics and kinematics than walking at early knee flexion under physiological-like quadriceps loading
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DOI：
10.1016/j.jbiomech.2009.07.007
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发表时间：
2009-11-13
影响因子：
2.4
通讯作者：
Heller, Markus O.
中科院分区：
文献类型：
--
作者：
Goudakos, Ioannis G.;Koenig, Christian;Heller, Markus O.
爬楼梯过程中的机械环境与髌股关节疼痛有关，但负荷对这种情况的影响尚不清楚。假设与早期屈膝行走相比，爬楼梯时的负荷条件会导致更高的髌股压力，滑车上更多的侧向力分布，以及更多的膝盖骨的侧移和倾斜。运动学测量的光学标记被固定在8个身体膝盖上，这些身体膝盖在12度和30度屈膝时的行走和爬楼梯循环中加载了肌肉力量。使用压敏膜测定了接触力学。屈膝12度。爬楼梯负荷的峰值压力(p=0.012)、侧向力分布(p=0.012)和侧向倾斜度(p=0.012)均高于步行负荷，而平均压力(p=0.069)和接触面积(p=0.123)无显著差异。在膝关节屈曲30度时，虽然与步行负荷相比，爬楼梯导致显著更高的髌股平均压力(p=0.012)和峰值压力(p=0.012)、接触面积(p=0.025)和倾斜度(p=0.017)，但内侧力分布(p=0.674)没有显著差异。在膝关节屈曲12度(p=0.093)和30度(p=0.575)时，步行和爬楼梯之间的髌骨移位没有显著差异。因此，在屈膝早期，爬楼梯比水平行走更具挑战性，其接触力学和运动学更具挑战性。在爬楼梯的过程中，髌股压力、侧向力分布和侧向倾斜的增加，为在这一活动中经常经历的髌股疼痛提供了可能的生物力学解释。(C)2009爱思唯尔有限公司。保留所有权利。
The mechanical environment during stair climbing has been associated with patellofemoral pain, but the contribution of loading to this condition is not clearly understood. It was hypothesized that the loading conditions during stair climbing induce higher patellofemoral pressures, a more lateral force distribution on the trochlea and a more lateral shift and tilt of the patella compared to walking at early knee flexion. Optical markers for kinematic measurements were attached to eight cadaveric knees, which were loaded with muscle forces at instances of walking and stair climbing cycles at 12 degrees and 30 degrees knee flexion. Contact mechanics were determined using a pressure sensitive film. At 12 degrees knee flexion. stair climbing loads resulted in higher peak pressure (p = 0.012) than walking, more lateral force distribution (p = 0.012) and more lateral tilt (p = 0.012), whilst mean pressure (p = 0.069) and contact area (p = 0.123) were not significantly different. At 30 degrees knee flexion, although stair climbing compared to walking loads resulted in significantly higher patellofemoral mean (p = 0.012) and peak pressures (p = 0.012), contact area (p = 0.025), as well as tilt (p = 0.017), the medial-lateral force distribution (p = 0.674) was not significantly different. No significant differences were observed in patellar shift between walking and stair climbing at either 12 degrees (p, = 0.093) or 30 degrees (p = 0.575) knee flexion. Stair climbing thus leads to more challenging patellofemoral contact mechanics and kinematics than level walking at early knee flexion. The increase in patellofemoral pressure, lateral force distribution and lateral tilt during stair climbing provides a possible biomechanical explanation for the patellofemoral pain frequently experienced during this activity. (C) 2009 Elsevier Ltd. All rights reserved.