在负重步态任务中研究平面对女性和男性膝关节总关节力矩的贡献。

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2025-03-19 eCollection Date: 2025-03-01 DOI:10.1177/23259671251322785
Kellen T Krajewski, Camille C Johnson, Qi Mi, Shawn D Flanagan, William J Anderst, Christopher Connaboy
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引用次数: 0

摘要

背景:军事人员在战斗角色观察到膝关节骨关节炎的高患病率。膝关节总关节力矩(KTJM)和膝关节内收力矩百分比贡献(KAM%)与膝关节骨性关节炎有关。据推测,性别、负重和强制运动模式,如强制行进(FM)会改变膝关节的力学。本研究的目的是确定“军事相关”负荷大小、运动模式和性别对新兵年龄成人在短时间步态任务中的KTJM及其平面百分比贡献的影响。假设:与较低负荷或无负荷相比,最大负荷和FM将显著增加KAM对KTJM的贡献。此外,无论实验条件如何,女性对KTJM的贡献都比男性大。研究设计:实验室对照研究。方法:20名年龄在18-35岁的健康成年人(男10名,女10名)在无负荷(体重)、额外负荷为体重的45%和额外负荷为体重的55%的情况下进行跑步和FM试验。KTJM与各运动平面的百分比贡献一起计算:膝关节屈曲力矩(KFM%), KAM%和膝关节旋转力矩(KRM%)。采用3 × 2 × 2混合模型方差分析,评价负重、运动方式和性别对站立阶段多个步态事件中KTJM、KFM%、KAM%和KRM%的影响。结果:FM比脚跟着地时表现出更大的KTJM (P < 0.001)。跑步组的KAM% (P = 0.01)和KRM% (P < 0.001)高于跑步组。在中期,各负荷条件下,跑步表现出的KTJM均高于FM (P < 0.001);与垂直地面反力峰值和中点跑相比,FM跑的KAM% (P < 0.001)和KRM% (P = 0.002)更高。男性在足跟撞击(P = 0.02)和中站(P = 0.04)时表现出更高的KAM%,这与运动模式无关。结论:负重增加KAM%的幅度与观察到的膝关节骨关节炎人群相似,特别是在执行FM时。有趣的是,男性比女性表现出更高的KAM%,这表明相对负载承载对运动执行的不同策略。临床相关性:在负重步态任务中筛选更高KAM%的新兵可以识别需要专门培训以降低膝骨关节炎发展风险的个体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining Planar Contributions to Knee Total Joint Moment Between Women and Men During Loaded Gait Tasks.

Background: Military personnel in combat roles observe a high prevalence of knee osteoarthritis. Knee total joint moment (KTJM) and the knee adduction moment percentage contribution (KAM%) of KTJM have been linked to knee osteoarthritis. It is postulated that sex, load carriage, and imposed locomotion patterns such as forced marching (FM) alter mechanics of the knee. The purpose of this study was to determine the effects of "military-relevant" load magnitudes, locomotion patterns, and sex on KTJM and its planar percentage contributions in recruit-aged adults during short-duration gait tasks.

Hypothesis: The greatest load magnitude and FM will significantly increase KAM contribution to KTJM compared with lower magnitudes or no load. Additionally, women will exhibit greater KAM contribution to KTJM compared with men regardless of experimental condition.

Study design: Controlled laboratory study.

Methods: Twenty healthy recruit-aged (18-35 years) adults (10 male, 10 female) executed trials of running and FM with no load (BW), an additional load of 45% of BW, and an additional load of 55% of BW. KTJM was calculated along with each plane of motion percentage contribution: knee flexion moment (KFM%), KAM%, and knee rotation moment (KRM%). A 3 × 2 × 2 mixed model analysis of variance was used to evaluate the effects of load carriage, locomotion pattern, and sex on KTJM, KFM%, KAM%, and KRM% at multiple gait events of stance phase.

Results: FM exhibited a greater (P < .001) KTJM than running at heel strike. Running had greater KAM% (P = .01) and KRM% (P < .001) compared with FM. At midstance, running exhibited greater (P < .001) KTJM than FM for each load condition; however, FM had greater KAM% (P < .001) and KRM% (P = .002) compared with running at peak vertical ground reaction force and midstance. Men exhibited greater KAM% at heel strike (P = .02) independent of locomotion pattern and at midstance (P = .04) for FM.

Conclusion: Load carriage increases KAM% to a magnitude similarly observed in populations with knee osteoarthritis, especially when executing FM. Interestingly, men exhibited greater KAM% than women, suggesting differing strategies to motor execution with relative load carriage.

Clinical relevance: Screening recruits for greater KAM% during loaded gait tasks may identify individuals in need of specialized training to reduce the risk of knee osteoarthritis development.

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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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