疼痛相关恐惧诱导健康女性和前交叉韧带重建女性的异常落跳着陆生物力学。

IF 3.3 2区 医学 Q1 ORTHOPEDICS
Robert I Dudley, Everett B Lohman, Lida Gharibvand, Christopher S Patterson
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引用次数: 0

摘要

目的:前交叉韧带(ACL)断裂是一种常见的损伤,通常由着陆或减速任务中异常的生物力学引起。疼痛相关恐惧是运动恐惧症的一个组成部分,与前交叉韧带重建(ACLr)患者的功能不良和运动模式改变有关,然而,疼痛相关恐惧对着陆机制的影响尚不清楚。本研究的目的是研究疼痛相关的恐惧对ACLr人群和健康女性着陆运动模式的影响。方法:32名女性(有ACLr病史的娱乐活动15名,无ACLr病史的娱乐活动17名)参与研究。参与者进行了五项试验,包括跳降(DJ)任务(基线),利用电刺激诱发疼痛相关恐惧的疼痛刺激(PS)熟悉任务,以及在PS威胁下进行后续一轮的DJ (PS威胁)。下肢和躯干运动学、地面反作用力(GRF)数据和肌肉激活分析。结果:在基线时,ACLr参与者的TSK-11得分(21±5.5)高于健康参与者(17±3.4)(p = 0.007)。在两组中,PS干预均显著增加了疼痛相关恐惧(ACLr)。结论:疼痛相关恐惧改变了健康和ACLr女性的着陆生物力学。这可能意味着与疼痛相关的恐惧是与前交叉韧带损伤风险相关的运动改变的一个因素。证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pain-related fear induces aberrant drop jump landing biomechanics in healthy and anterior cruciate ligament reconstructed females.

Purpose: Rupture of the anterior cruciate ligament (ACL) is a prevalent and debilitating injury typically arising from aberrant biomechanics during landing or deceleration tasks. Pain-related fear, a component of kinesiophobia, has been associated with poor functional outcomes and altered movement patterns in individuals with ACL reconstruction (ACLr), however, the influence of pain-related fear on landing mechanics remains unclear. The purpose of this investigation was to examine the effects of pain-related fear on landing movement patterns in a population of ACLr and healthy females.

Methods: Thirty-two females (15 recreationally active with a history of ACLr and 17 recreationally active with no history of ACLr) took part. Participants performed five trials of a drop jump (DJ) task (Baseline), underwent a pain stimulus (PS) familiarization task utilizing an electrical stimulus to induce pain-related fear, and performed a subsequent round of DJs while under threat of PS (PS-threat). Lower extremity and trunk kinematics, ground reaction force (GRF) data and muscle activation were analyzed.

Results: At baseline, ACLr participants scored higher (21 ± 5.5) on the TSK-11 compared to healthy participants (17 ± 3.4) (p = 0.007). For both groups, the PS intervention significantly increased pain-related fear (ACLr p < 0.001; Healthy p < 0.001). When comparing baseline to PS-threat trials, ACLr participants experienced a significant increase in peak GRF (p = 0.005), decreases in hip (p = 0.003) and knee (p = 0.005) flexion, decreased contact time (p = 0.006) and decreased muscle preactivation for all muscles tested (p < 0.05). Healthy participants experienced significant increases in peak GRF (p = 0.014) and decreased hip (p = 0.005) and trunk peak (p = 0.004) flexion.

Conclusions: Pain-related fear alters landing biomechanics in healthy and ACLr females. This may implicate pain-related fear as a contributor to movement alterations commonly associated with ACL injury risk.

Level of evidence: Level III.

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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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