背景:步宽是额面中的空间变量,定义为初始接触时双侧脚的脚跟(短跑过程中的前脚)之间的中外侧距离。步长的变化可能会影响下肢生物力学。本系统综述旨在综合已发表的发现,以确定步宽的急性变化对运动生物力学的影响,并为预防伤害和增强运动表现提供启示。
方法:确定了文献,选定,并按照系统评价的方法进行评价。四个电子数据库(WebofScience,MEDLINE通过PubMed,Scopus,和ScienceDirect)一直搜索到2023年5月,并基于PICO模型制定纳入标准。使用Downs和Black检查表评估研究质量,并总结测量参数。
结果:系统评价包括23篇文章和399名参与者。纳入的23项研究的平均质量评分为9.39(共14项)。步长改变了矢状的运动学和动力学,额叶,和下肢的横向平面,如峰值后脚外翻角度和力矩,峰值髋关节内收角度和力矩,膝关节屈曲力矩,峰值膝部内部旋转角度,以及膝盖外部旋转力矩。台阶宽度的改变有可能改变运动过程中的稳定性和姿势,并且有证据表明,步宽变化会立即产生生物力学影响,以改变近端运动学和影响载荷变量的线索。
结论:步行过程中步宽的短期变化,跑步,短跑影响下肢多个生物力学。更窄的步幅可能导致行走和跑步过程中下肢的平衡差和更高的冲击负荷,并可能限制运动员的短跑表现。增加台阶宽度可能有利于损伤康复,即,髌股疼痛综合征患者,髂胫带综合征或胫骨骨应力性损伤。更宽的台阶增加了支撑基础,通常会增强平衡控制,这反过来可以降低日常活动中跌倒的风险。因此,在临床实践中提出了改变台阶宽度作为简单且非侵入性的治疗方法。
BACKGROUND: Step width is a spatial variable in the frontal plane, defined as the mediolateral distance between the heel (forefoot during sprinting) of bilateral feet at initial contact. Variations in step width may impact the lower limb biomechanics. This systematic
review aimed to synthesize the published findings to determine the influence of acute changes in step width on locomotion biomechanics and provide implications for injury prevention and enhanced sports performance.
METHODS: Literature was identified, selected, and appraised in accordance with the methods of a systematic
review. Four electronic databases (Web of Science, MEDLINE via PubMed, Scopus, and ScienceDirect) were searched up until May 2023 with the development of inclusion criteria based on the PICO model. Study quality was assessed using the Downs and Black checklist and the measured parameters were summarized.
RESULTS: Twenty-three articles and 399 participants were included in the systematic
review. The average quality score of the 23 studies included was 9.39 (out of 14). Step width changed the kinematics and kinetics in the sagittal, frontal, and transverse planes of the lower limb, such as peak rearfoot eversion angle and moment, peak hip adduction angle and moment, knee flexion moment, peak knee internal rotation angle, as well as knee external rotation moment. Alteration of step width has the potential to change the stability and posture during locomotion, and evidence exists for the immediate biomechanical effects of variations in step width to alter proximal kinematics and cues to impact loading variables.
CONCLUSIONS: Short-term changes in step width during walking, running, and sprinting influenced multiple lower extremity biomechanics. Narrower step width may result in poor balance and higher impact loading on the lower extremities during walking and running and may limit an athlete\'s sprint performance. Increasing step width may be beneficial for injury rehabilitation, i.e., for patients with patellofemoral pain syndrome, iliotibial band syndrome or tibial bone stress injury. Wider steps increase the supporting base and typically enhance balance control, which in turn could reduce the risks of falling during daily activities. Altering the step width is thus proposed as a simple and non-invasive treatment method in clinical practice.