背景:对肌肉骨骼模型进行了改进,以估计准确的膝关节压缩力(KCF),并已用于揭示KCF与肌肉无力之间的因果关系。以前的研究已经探索了步态过程中肌肉无力如何影响KCF;然而,在需要更深的膝关节屈曲的活动中,肌肉无力的影响可能更大(例如,楼梯行走)比其他活动(例如,步态),因为关节面的膝关节接触面积小。
目的:探讨在楼梯行走过程中肌肉无力如何影响KCF。
方法:十个年轻人以舒适的速度执行楼梯上升和下降任务。根据之前的一项研究,我们创建了股直肌肌无力模型,腹肌(VAS),臀中肌(Gmed),和臀大肌(Gmax),计算了楼梯行走过程中的内侧和外侧KCF(KCFmed和KCFlat)。
结果:类似于步态,在楼梯上升和下降期间,Gmed弱点增加了KCFmed,降低了KCFlat。然而,与步态不同,Gmax弱点在楼梯上升期间增加了KCFmed,而VAS弱点在楼梯上升和下降期间减少了KCFmed和KCFlat。此外,与步态相比,楼梯行走过程中KCF的百分比变化相似(或较大)。
结论:考虑到每种肌肉无力引起的KCF改变,Gmax和Gmed的弱点可能导致软骨丢失和膝盖疼痛,和VAS的弱点可能导致低稳定性的膝盖。楼梯行走期间的症状可能有助于准确识别需要康复的肌肉。
BACKGROUND: The musculoskeletal models have been improved to estimate accurate knee compression force (KCF) and have been used to reveal the causal relationship between KCF and muscle weakness. Previous studies have explored how muscle weakness influences the KCF during gait; however, the influence of muscle weakness is possibly larger during activities that require deeper knee flexion (e.g., stair ambulation) than other activities (e.g., gait) because of the small knee contact area of articular surfaces.
OBJECTIVE: To explore how muscle weakness influences the KCF during stair ambulation.
METHODS: Ten young adults performed stair ascent and descent tasks at a comfortable speed. Based on a previous study, we created muscle weakness models of rectus femoris (RF), vastus muscles (VAS), gluteus medius (Gmed), and gluteus maximus (Gmax), and the medial and lateral KCF (KCFmed and KCFlat) during stair ambulation were calculated.
RESULTS: Similar to the gait, the Gmed weakness increased KCFmed and decreased KCFlat during stair ascent and descent. Whereas, unlike the gait, the Gmax weakness increased KCFmed during stair ascent and the VAS weakness decreased KCFmed and KCFlat during stair ascent and descent. Moreover, the percentage changes in KCF were similar (or large) during stair ambulation compared with those during gait.
CONCLUSIONS: Considering the KCF alterations caused by each muscle weakness, the weaknesses in Gmax and Gmed might lead to cartilage loss and pain in the knee, and the VAS weakness might lead to low stability of the knee. The symptom during stair ambulation might help precisely identify the muscle requiring rehabilitation.