摘要
目的:分析普通人、运动员和前交叉韧带(ACL)损伤患者平地步行时的膝关节步态图特征,探讨可早期识别ACL损伤风险的潜在运动学指标。方法:2021年12月至2022年3月在南方医科大学招募在校大学生78名,包括39名普通大学生(普通人组)和39名大学生运动员(运动员组),在广东省人民医院骨科招募26例ACL损伤患者(患者组)。普通人组男20例,女19例;中位年龄为19(18,21)岁;运动员组男22例,女17例;中位年龄为19(18,20)岁;患者组男23例,女3例;中位年龄为20(19,20)岁。利用便携式膝关节运动捕捉系统采集受试者在跑步机上以3 km/h速度行走时的膝关节步态图,比较3组受试者的膝关节内外翻角度、内外旋角度、屈伸角度和胫骨相对股骨的前后、内外、上下位移等。结果:3组受试者之间除性别外其他一般资料比较差异均无统计学意义(P>0.05),具有可比性。3组受试者整个步态周期内(1%~100%)的膝关节内外翻角度、承重反应期(9%~10%)的膝关节内外旋角度、支撑相和摆动相(1%~27%、29%~100%)的膝关节屈伸角度、承重反应期(1%~3%)和摆动相末期(96%~98%)的前后位移、支撑相中期(15%~19%)、末期(29%~33%、36%~43%)和摆动相(68%~94%)的上下位移、支撑相中期至摆动相中期(12%~82%)的内外位移比较差异均有统计学意义(P<0.05)。普通人组、运动员组受试者的最大内外翻角度(-10.89°±4.55°、-12.20°±4.38°)显著大于患者组(-5.44°±3.72°),普通人组受试者支撑相中期内外位移[3.69(0.13,7.25)mm]显著大于运动员组、患者组受试者[-0.59(-6.65,5.24)、0.96(-1.54,3.89)mm],差异均有统计学意义(P<0.05)。结论:大学生运动员的步态与普通大学生、ACL损伤患者的步态比较存在显著差异,内外翻角度和内外位移指标可作为早期识别ACL损伤风险的遴选指标。
Objective To characterize the knee gait maps of ordinary people,athletes and patients with anterior cruciate ligament(ACL)injury when walking on a level ground in order to identify potential kinematic indicators for early identification of ACL injury.Methods From December 2021 to March 2022,39 ordinary college students(normal group)and 39 college athletes(athlete group)were recruited in Southern Medical University,and 26 patients with ACL injury(patient group)were recruited at the Department of Orthopedics,Guangdong Provincial People's Hospital.The normal group consisted of 20 males and 19 females with a median age of 19(18,21)years;the athlete group consisted of 22 males and 17 females with a median age of 19(18,20)years;the patient group consisted of 23 males and 3 females with a median age of 20(19,20)years.A portable knee joint motion capture system was used to collect the knee gait maps of the subjects walking at a speed of 3 km/h on a treadmill.The knee varus and valgus angles,internal and external rotation angles,flexion and extension angles during the movement,and anteroposterior,medial-lateral superior-inferior displacements of the tibia relative to the femur were compared between the 3 groups.Results There was no significant difference in the general data among the 3 groups except for gender,showing they were comparable(P>0.05).There were significant differences in the varus and valgus angles during the whole gait cycle(1%to 100%),internal and external rotation angles during the weight-bearing response period(9%to 10%),flexion and extension angles during the stance phase and swing phase(1%to 27%,29%to 100%),anteroposterior displacements during the weight-bearing reaction phase(1%to 3%)and at the end of the swing phase(96%to 98%),superior-inferior displacements at the middle support phase(15%to 19%),the end of the support phase(29%to 33%,36%to 43%)and the swing phase(68%to 94%),and medial-lateral displacements at the middle stance phase and the middle swing phase(12%to 82%)among the 3 groups(P<0.05).The maximum varus and valgus angles(-10.89°±4.55°,-12.20°±4.38°)of the subjects in the normal group and the athlete group were significantly greater than those in the patient group(-5.44°±3.72°)(P<0.05).The medial-lateral displacement at the middle support phase[3.69(0.13,7.25)mm]of the subjects in the normal group was significantly larger than those in the athlete group and the patient group[-0.59(-6.65,5.24)mm,0.96(-1.54,3.89)mm](P<0.05).Conclusions The gait of college athletes is significantly different from that of ordinary college students and that of patients with ACL injury.Indexes like the varus and valgus angles and the medial-lateral displacement may be used as potential indictors for early identification of ACL injury.
作者
姜江
曾小龙
汪斐
贾蕊
谢珍艳
钟国庆
张余
李鉴轶
宋军
Jiang Jiang;Zeng Xiaolong;Wang Fei;Jia Rui;Xie Zhenyan;Zhong Guoqing;Zhang Yu;Li Jianyi;Song Jun(Department of Anatomy,Guangdong Provincial Key Laboratory of Medical Biomechanics,School of Basic Medical Sciences,Southern Medical University,Guangzhou 510515,China;School of Medicine,South China University of Technology,Guangzhou 510641,China;Department of Orthopaedics,Guangdong Provincial People's Hospital,Guangzhou 510080,China;Medical Experimental Center,The Third Hospital Affiliated to Southern Medical University,Guangzhou 510630,China;General Education Department,Southern Medical University,Guangzhou 510515,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第9期812-818,共7页
Chinese Journal of Orthopaedic Trauma
基金
国家重点研发计划项目(2017YFC0110602)
广州市科技计划项目(201704020069)。
关键词
膝关节
前交叉韧带
创伤和损伤
步态图
大学生
运动员
Knee joint
Anterior cruciate ligament
Wounds and injuries
Gait map
College students
Athletes
