股骨大转子压迫对骶髂关节紊乱患者坐椅困难的影响：一项临床和数值研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-08-08 DOI:10.1016/j.clinbiomech.2025.106647

Takeshi Sasaki , Daisuke Kurosawa , Ryota Toyohara , Tomoya Takahashi , Yukiko Endo , Asagi Sato , Toshiro Ohashi , Eiichi Murakami

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引用次数: 0

摘要

骶髂关节紊乱通常会引起腰痛，久坐会加重腰痛，从而影响日常活动。尽管临床观察表明，坐位时压迫大转子可改善骶髂关节疼痛，但其生物力学效应尚不清楚。我们研究了它们的临床效果，并通过计算机分析验证了它们的有效性。方法我们纳入了5例骶髂关节紊乱患者和1例椎间盘源性疼痛患者，他们都经历了坐姿时的剧烈疼痛。使用手工坐式矫形器压迫大转子。我们调查了带和不带矫形器的最长坐位时间和患者的日常活动。此外，我们使用有限元分析可视化大转子受压下骨盆应力分布。使用矫形器后，坐位时间从平均12.0±5.7 min提高到46.3±11.1 min （p = 0.0054）。日常活动功能也有所改善。坐位时骶髂关节表面的平均等效应力和最小主应力在平行于股骨颈长轴的受压下增加，在水平受压时减小。在所有情况下，每种负荷条件下的韧带负荷都是一致的，骶结节、骶棘、骶髂前韧带和耻骨韧带的负荷都有所减少。本研究证明了坐式矫形器的临床疗效，并基于计算机分析表明，坐位时骶髂关节表面的生物力学效应随着大转子施加压力的方向而变化。这些发现可能有助于分类坐姿相关骶髂关节疼痛的机制，并为更有针对性的治疗策略提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effect of femoral greater trochanter compression on chair-sitting difficulty due to sacroiliac joint disorder: A clinical and numerical study

Background

Sacroiliac joint disorder commonly causes low back pain, aggravated by sitting, thereby affecting daily activities. Although clinical observations suggest that compression of the greater trochanter may improve sacroiliac joint pain while sitting, the biomechanical effects remain unknown. We investigated their clinical effects and validated them through in silico analysis.

Methods

We included five patients with sacroiliac joint disorder and one with discogenic pain, all of whom experienced severe pain while sitting. A handmade seating orthosis was used to compress the greater trochanters. We investigated the maximum sitting time with and without the orthosis and the patients' daily activities. Additionally, we visualized pelvic stress distribution under greater trochanter compression using finite element analysis.

Findings

Sitting time improved from a mean of 12.0 ± 5.7 min to 46.3 ± 11.1 with the use of the orthosis (p = 0.0054). Daily activity function also improved. Mean equivalent and minimum principal stresses on the sacroiliac joint surface during sitting increased under compression parallel to the long axis of the femoral neck and decreased with horizontal compression. Ligament loads under each loading condition were consistent across all scenarios, with a decrease in the load on the sacrotuberous, sacrospinous, anterior sacroiliac, and pubic ligaments.

Interpretation

This study demonstrated the clinical efficacy of the seating orthosis and showed that biomechanical effects on the sacroiliac joint surface varied with the direction of applied pressure to the greater trochanter during sitting, based on in silico analysis. These findings may help classify the mechanisms underlying sitting-related sacroiliac joint pain and inform more targeted treatment strategies.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.