ASB Clinical Biomechanics Award Winner 2006 Prospective study of the biomechanical factors associated with iliotibial band syndrome
ASB Clinical Biomechanics Award Winner 2006 Prospective study of the biomechanical factors associated with iliotibial band syndrome
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DOI：
10.1016/j.clinbiomech.2007.07.001
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发表时间：
2007-11-01
影响因子：
1.8
通讯作者：
Hamill, Joseph
中科院分区：
文献类型：
--
作者：
Noehren, Brian;Davis, Irene;Hamill, Joseph
背景：髂胫束综合征是跑步者膝关节外侧疼痛的主要原因。尽管其发病率很高，但人们对导致这种综合征的生物力学知之甚少。这项研究的目的是前瞻性地比较患上髂胫束综合征的一组女性跑步者与健康对照组之间的下肢运动学和动力学。据推测，患有髂胫束综合征的跑步者将表现出更大的峰值髋关节内收、膝关节内旋、后足外翻，而在脚跟着地时膝关节屈曲程度没有差异。此外，髂胫束综合征组预计会有更大的髋关节外展、膝关节外旋和后足内翻。一组健康的女性休闲跑步者接受了仪表化步态分析，然后进行了两年的跟踪调查。18名跑步者患上了髂胫束综合征。他们最初的跑步机制与一组年龄和里程匹配的对照组进行了比较，这些对照组没有膝盖或臀部疼痛的病史。比较了跑步站立阶段的最大髋角、最大膝角、最大后足角和最大力矩。在五个正在进行的试验中，对感兴趣的变量进行平均，然后跨组进行平均。髂胫束综合征组表现出明显更大的髋关节内收和膝关节内旋。然而，两组间的后足外翻和膝关节屈曲情况相似。不同组间的力矩无差异。髂胫束综合征的发展似乎与髋关节峰值内收增加和膝关节内旋有关。这些联合运动可能会增加髂胫束的张力，使其压迫股骨外侧髁。这些数据表明，治疗干预应侧重于通过加强、伸展和神经肌肉再教育来控制这些次级平面运动。(C)2007爱思唯尔有限公司。保留所有权利。
Background Iliotibial band syndrome is the leading cause of lateral knee pain in runners. Despite its high prevalence, little is known about the biomechanics that lead to this syndrome. The purpose of this study was to prospectively compare lower extremity kinematics and kinetics between a group of female runners who develop iliotibial band syndrome compared to healthy controls. It was hypothesized that runners who develop iliotibial band syndrome will exhibit greater peak hip adduction, knee internal rotation, rearfoot eversion and no difference in knee flexion at heel strike. Additionally, the iliotibial band syndrome group were expected to have greater hip abduction, knee external rotation, and rearfoot inversion moments.Methods. A group of healthy female recreational runners underwent an instrumented gait analysis and were then followed for two years. Eighteen runners developed iliotibial band syndrome. Their initial running mechanics were compared to a group of age and mileage matched controls with no history of knee or hip pain. Comparisons of peak hip, knee, rearfoot angles and moments were made during the stance phase of running. Variables of interest were averaged over the five running trials, and then averaged across groups.Findings. The iliotibial band syndrome group exhibited significantly greater hip adduction and knee internal rotation. However, rearfoot eversion and knee flexion were similar between groups. There were no differences in moments between groups.Interpretation. The development of iliotibial band syndrome appears to be related to increased peak hip adduction and knee internal rotation. These combined motions may increase iliotibial band strain causing it to compress against the lateral femoral condyle. These data suggest that treatment interventions should focus on controlling these secondary plane movements through strengthening, stretching and neuromuscular re-education. (C) 2007 Elsevier Ltd. All rights reserved.