护膝干预影响跑步者髌股关节痛主观痛感、下肢运动学和动力学的性别差异

Effects of knee sleeve on perceived pain and lower extremity kinematics and kinetics in male and female runners with patellofemoral pain

背景:护膝常被跑步爱好者用于预防和治疗髌股关节痛,但其所起到的干预作用机制仍不清楚。目的:确定护膝对不同性别髌股关节痛跑步爱好者跑步时主观痛感、下肢运动学和动力学特征的影响。方法:选取11名男性和9名女性髌股关节痛跑步爱好者作为受试者,通过目测类比量表、红外运动捕捉系统和测力台采集受试者在有、无穿戴髌骨稳定型护膝跑步时的主观痛感、运动学和动力学数据。研究通过北京体育大学运动科学实验伦理委员会批准,批准号:2020021H。参与试验的受试者均为自愿参加,对试验过程完全知情同意。结果与结论:(1)男性和女性受试者在有护膝时跑步的目测类比量表得分小于无护膝时(P<0.01);(2)女性受试者在有护膝时跑步缓冲期的最大膝屈角度小于无护膝时(P<0.01),但男性在有、无护膝时跑步缓冲期的最大膝屈角度未出现差异(P>0.05);男性和女性受试者在有护膝时跑步缓冲期的最大髋内收角度小于无护膝时(P<0.01);男性和女性患者在有护膝时跑步缓冲期的膝外展(P<0.01)和外旋力矩峰值(P<0.01)大于无护膝时;(3)结果说明,护膝降低了男性和女性髌股关节痛跑步爱好者跑步时的主观痛感;减小了女性跑步时的最大膝屈角度和髋内收角度,以及男性跑步时的最大髋内收角度,护膝对下肢运动学特征的影响具有性别特异性;增大了男性和女性跑步时的膝外展和外旋力矩峰值,护膝可能引起膝关节负荷增大。

BACKGROUND:Knee sleeve is generally applied to prevent and treat patellofemoral pain in runners,while the intervention effects are still unclear.OBJECTIVE:To determine the effects of knee sleeve on perceived pain,lower extremity kinematics and kinetics in runners of different sexes with patellofemoral pain.METHODS:Eleven male and nine female runners with patellofemoral pain were recruited as the participants.Each participant performed the biomechanical tests with and without a patellar-stabilizing knee sleeve.Perceived pain was evaluated by a visual analogue scale.Kinematics and kinetics data during running were collected using a motion capture system and synchronized force platforms.The study protocol was approved by the Sports Science Experimental Ethics Committee of Beijing Sport University,with an approval No.2020021H.All the participants were volunteers for this trial and fully informed of the trial process.RESULTS AND CONCLUSION:When running with a knee sleeve,visual analogue scale scores were lower than those without a knee sleeve in both males and females(P<0.01).When running with a knee sleeve,peak knee flexion angle in the landing phase was less than that without a knee sleeve in females(P<0.01);however,there was no significant difference in males with or without a knee sleeve(P>0.05).When running with a knee sleeve,peak hip adduction angle in the landing phase was less than that without a knee sleeve in both males and females(P<0.01).When running with a knee sleeve,peak knee abduction(P<0.01)and external rotation moments(P<0.01)in the landing phase were higher than those without a knee sleeve in both males and females.In conclusion,the use of knee sleeve can alleviate perceived pain in both male and female runners who suffer from patellofemoral pain;reduce the peak knee flexion angle and hip adduction angle in female runners with patellofemoral pain,and reduce the peak hip adduction angle in male runners with patellofemoral pain,indicating a sex-specific effect of knee sleeve on lower extremity kinematics;and increase the peak knee abduction and external rotation moments in both male and female runners with patellofemoral pain,indicating the use of knee sleeve may increase the knee joint loading.