跆拳道运动对跟骨骨皮质厚度与骨小梁应力分布的影响

Influence of taekwondo competition on cortical thickness in the calcaneus and stress distribution in the trabecular bone

背景:研究报道,长期高冲击性运动应力可使骨骼产生适应性变化,对运动者骨皮质厚度和骨小梁密度等都存在一定影响。跟骨骨密度常作为描述骨量变化的评判依据。目的:通过测量跆拳道运动者跟骨骨皮质厚度和骨小梁密度及分布趋势,为足部功能解剖学、影像解剖学、足运动生物力学和足踝外科研究提供参考依据。方法:选取10名跆拳道高水平运动员为试验组,9名普通体育爱好者为对照组,两组受试者均为男性,身高、体质量和年龄均无显著差异。采用GE64层螺旋CT扫描受试者双侧足部,应用Mimics 21.0软件测量跟骨结节、外侧突、内侧突骨皮质厚度和骨小梁密度。测量矢状面、水平面和冠状面影像视窗内骨小梁长度、宽度和高度。研究方案的实施符合中北大学对研究的相关伦理要求,受试者为自愿参加,对测试方法和指标完全知情同意。结果与结论:①试验组左右跟骨结节、内侧突骨皮质厚度均大于对照组(P<0.05);试验组左跟骨外侧突、内侧突和跟骨结节骨皮质厚度均大于右跟骨(P<0.05);②试验组左右跟骨外侧突、内侧突骨小梁骨密度均大于对照组(P<0.01);③试验组左右跟骨(矢状面、水平面和冠状面)骨小梁长度、宽度、高度均大于对照组(P<0.05);④跆拳道运动击打和跳跃产生的应力、跟腱和足底肌肉韧带牵拉,可促使跟骨骨皮质厚度增加、骨小梁密度增加及形态发生改变,表现为骨小梁长度、宽度和高度增加,说明跟骨受力部位骨皮质和骨小梁发生了适应性改变,而且左右足都有改变。

BACKGROUND:Studies have shown that long-term high-impact exercise stress can cause adaptive changes in the bones,which have certain effects on cortical bone thickness and trabecular bone density in athletes.Calcaneus bone density is often used as a basis for judging changes in bone mass.OBJECTIVE:To measure the cortical thickness of the calcaneus and trabecular bone density and distribution trend in Taekwondo athletes,in order to provide reference for research on foot functional anatomy,imaging anatomy,foot movement biomechanics and ankle surgery.METHODS:Ten high-level Taekwondo athletes were enrolled as experimental group and nine ordinary sports enthusiasts as control group.The subjects in the two groups were all male,and there were no significant differences in height,weight and age.GE64-slice spiral CT was used to scan the subjects’feet on both sides,and Mimics 21.0 software was used to measure the cortical thickness of the calcaneal tubercle,lateral process,and medial process as well as trabecular bone density.The length,width and height of the trabecular bone in the sagittal,horizontal and coronal image windows were measured.RESULTS AND CONCLUSION:The thickness of the left and right calcaneal tuberosity and medial process in the experimental group was greater than that in the control group(P<0.05).In the experimental group,the thickness of the cortical bone of the left lateral process,medial process and calcaneal tubercle was greater than that of the right lateral process,medial process and calcaneal tubercle(P<0.05).The bone mineral density of the left and right lateral calcaneus and medial process of the experimental group was higher than that of the control group(P<0.01).The length,width and height of the trabecula of the left and right calcaneus(sagittal,horizontal and coronal planes)in the experimental group were larger than those in the control group(P<0.05).Taekwondo strikes and jumps produce the stress and traction of the Achilles tendon and plantar muscle ligament,which can increase the cortical thickness of the calcaneus,increase the density of the trabecular bone,and change the shape of the trabecular bone,manifested by the increase in trabecular length,width and height,indicating that the cortical bone and trabecular bone of the calcaneus at force part have undergone adaptive changes,and the left and right feet have changed.