膝痛对髌股关节痛业余跑者跑步和落地起跳缓冲期膝关节生物力学特征的影响

Effects of Knee Pain on Knee Biomechanics of Amateur Runners with Patellofemoral Pain in the Landing Phases of Running and Drop-Jumping

目的:对比髌股关节痛业余跑者在有痛和无痛2种状态下跑步和落地起跳缓冲期的运动学和动力学数据,确定膝痛对膝关节生物力学特征的影响。方法:筛查选取15名男性和10名女性髌股关节痛业余跑者作为受试者并完成研究。每名受试者分别在有痛和无痛2种状态下完成生物力学测试,膝痛的诱发与消除通过改变跑量完成。采集所有受试者在跑步和落地起跳时的膝关节运动学和动力学数据。采用混合设计的双因素方差分析确定疼痛状态与性别对跑步和落地起跳缓冲期膝关节生物力学特征的影响。结果:男性和女性髌股关节痛业余跑者在有痛状态下跑步(P=0.001)和落地起跳(P=0.011)缓冲期的最大膝外展角度小于无痛状态。男性和女性髌股关节痛业余跑者在有痛状态下落地起跳缓冲期的膝伸力矩峰值(P=0.003)和髌股关节应力峰值(P=0.001)小于无痛状态。结论:膝痛会降低男性和女性髌股关节痛业余跑者在跑步和落地起跳缓冲期的最大膝外展角度,以及落地起跳缓冲期的膝伸力矩峰值和髌股关节应力峰值。膝痛代偿性地降低了髌股关节负荷,可能属于一种保护机制。

Objective:To determine the effects of knee pain on knee biomechanics of amateur runners with patellofemoral pain(PFP),kinematic and kinetic data of amateur runners with PFP in the landing phases of running and drop-jumping were compared between pain conditions.Methods:15 male and 10 female amateur runners with PFP were selected as subjects and completed this study.Each participant was required to perform two biomechanical tests:with and without pain tests.Knee pain was induced or eliminated by changing the volume of running.Three-dimensional kinematics and kinetics data in the landing phases of running and drop-jumping were collected.A two-way analysis of variance with mixed design was performed to compare for each knee biomechanics between pain conditions and between sexes.Results:The peak knee abduction angle when running(P=0.001)and drop-jumping(P=0.011)with pain was significantly less than that without pain for both male and female amateur runners with PFP.The peak knee extension moment(P=0.003)and patellofemoral joint stress(P=0.001)when dropjumping with pain were significantly less than that without pain for both male and female amateur runners with PFP.Conclusions:Knee pain may decrease the peak knee abduction angle in the landing phase of running and drop-jumping,and decrease the peak knee extension moment and patellofemoral joint stress in the landing phase of drop-jumping for both male and female amateur runners with PFP.The compensation of knee pain may be a protective mechanism because of reducing the knee joint loading.