Clinical Biomechanics最新文献

Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial 膝骨关节炎患者六周生物反馈步态再训练计划：一项随机对照试验。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI: 10.1016/j.clinbiomech.2026.106776

Yi Wan , Polly McGuigan , James Bilzon , Logan Wade

Background

Knee osteoarthritis causes pain, can limits mobility and is linked to excessive knee loading. Gait retraining with biofeedback shows promise in reducing knee loading and improving pain and function, but optimal feedback strategies remain unclear. This study compared the effects of different biofeedback-based gait retraining approaches on knee joint loading, pain and functional outcomes.

Methods

Fifty individuals with knee osteoarthritis were randomised to gait pattern feedback group, knee moment feedback group, or control group. Participants underwent a six-week programme, with activity knee pain, functional ability and biomechanical assessments conducted at baseline, post-intervention, and one-month follow-up. Data were analysed using linear mixed models under an intention-to-treat approach.

Findings

All groups improved in functional ability and activity knee pain post-intervention (p < 0.001), with sustained benefits in the intervention groups (p < 0.001). Only the gait pattern group showed a lasting reduction in the 1st peak knee adduction moment during (−7.6%, p = 0.003; maintained at follow-up). No significant change in foot progression angle was observed in any group. Step width increased during stair ascent and sit-to-stand (p ≤ 0.010) and step length decreased during walking (p = 0.021) for all groups, but both changes were transient.

Interpretation

Gait retraining improves pain and function in individuals with knee OA, but gait pattern feedback uniquely reduces joint loading during walking, supporting the importance of target-specific personalised gait modifications for long-term biomechanical benefit.

背景：膝关节骨关节炎引起疼痛，可限制活动，并与过度的膝关节负荷有关。生物反馈的步态再训练在减轻膝关节负荷、改善疼痛和功能方面显示出希望，但最佳反馈策略仍不清楚。本研究比较了不同基于生物反馈的步态再训练方法对膝关节负荷、疼痛和功能结局的影响。方法：50例膝关节骨性关节炎患者随机分为步态模式反馈组、膝关节力矩反馈组和对照组。参与者进行了为期六周的计划，在基线、干预后和一个月的随访中进行了膝关节活动度、功能能力和生物力学评估。使用意向治疗方法下的线性混合模型分析数据。研究结果：所有组在干预后的功能能力和活动膝关节疼痛方面都有所改善(p)解释：步态再训练改善了膝关节OA患者的疼痛和功能，但步态模式反馈独特地减少了行走时的关节负荷，支持了针对特定目标的个性化步态修改对长期生物力学益处的重要性。

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引用次数: 0

Soft tissue injuries induce lumbar instability and intervertebral disc degeneration: A mechanobiological study based on a rabbit model 软组织损伤诱导腰椎不稳定和椎间盘退变：基于兔模型的力学生物学研究。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.clinbiomech.2026.106773

Pengren Luo , Jiawen Zhan , Boyu Zhang , Pingjin Xie , Pengchao Zhen , Zhefeng Jin , Tao Han , Liguo Zhu

Background

Lumbar instability, often associated with intervertebral disc degeneration, is a key contributor to chronic low back pain. However, the mechanobiological interplay between soft tissue injury and the onset of spinal instability remains poorly elucidated.This study aimed to develop and characterize a rabbit model of lumbar instability based on endogenous (ligamentous) and exogenous (muscular) soft tissue injuries, and to investigate the biomechanical and biological progression of intervertebral disc degeneration over time.

Methods

Fifty-four New Zealand white rabbits were randomly assigned to three groups: endogenous ligament injury, exogenous muscle injury, and control. Multiple evaluation methods—including X-ray imaging, finite element analysis, creep and fatigue testing, histological staining, TUNEL apoptosis detection, and Western blotting for Aggrecan, Collagen II, and Caspase-3—were conducted at 0, 4, 8, 16, and 24 weeks post-modeling.

Findings

Both injury models led to progressive lumbar instability and intervertebral disc degeneration, evidenced by decreased disc elasticity, increased displacement under load, and structural deterioration in imaging and histology. FEA revealed altered stress distribution and increased mechanical burden over time. Aggrecan and Collagen II expression significantly declined, while Caspase-3 levels and TUNEL-positive apoptotic cells increased, especially in the exogenous group.

Interpretation

Muscle and ligament injuries are sufficient to induce lumbar instability and promote progressive disc degeneration through biomechanical failure and apoptosis. These findings underscore the importance of early mechanical and biological interventions targeting soft tissue integrity to prevent intervertebral disc degeneration and lumbar instability.

背景：腰椎不稳定，通常与椎间盘退变相关，是慢性腰痛的一个关键因素。然而，软组织损伤与脊柱不稳定发病之间的机械生物学相互作用仍不清楚。本研究旨在建立基于内源性（韧带）和外源性（肌肉）软组织损伤的兔腰椎不稳定模型并对其进行表征，并研究椎间盘退变的生物力学和生物学进展。方法：54只新西兰大白兔随机分为内源性韧带损伤组、外源性肌肉损伤组和对照组。在造模后0、4、8、16和24周，对Aggrecan、Collagen II和caspase -3进行多种评估方法，包括x射线成像、有限元分析、蠕变和疲劳试验、组织学染色、TUNEL细胞凋亡检测和Western blotting。结果：两种损伤模型均导致进行性腰椎不稳定和椎间盘退变，表现为椎间盘弹性下降，载荷下位移增加，影像学和组织学结构恶化。有限元分析显示，随着时间的推移，应力分布发生变化，机械负荷增加。Aggrecan和Collagen II表达明显下降，Caspase-3水平和tunel阳性凋亡细胞增加，外源组尤为明显。解释：肌肉和韧带损伤足以引起腰椎不稳定，并通过生物力学失效和细胞凋亡促进椎间盘退变。这些发现强调了针对软组织完整性的早期机械和生物干预的重要性，以防止椎间盘退变和腰椎不稳定。

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引用次数: 0

Restraining effect of the newly developed elastomeric knee brace for anterior cruciate ligament-deficient knees using anterior displacement model 新研制的弹性膝支具对前交叉韧带缺损膝关节的抑制作用。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.clinbiomech.2026.106781

Junpil Song , Maki Koyanagi , Satoshi Morishita , Kouichi Mukai , Yoshiatsu Ikegami , Kai Hirata , Kazuhiko Nakano

Background

Knee braces are often prescribed for individuals with anterior cruciate ligament-deficient knees. Although rigid functional knee braces are limited to certain contact sports, soft knee braces can be used in almost all sports. However, few studies have investigated the restraining effect of soft knee braces. We developed an elastomeric knee brace with anatomical straps and no rigid hinges to improve its suitability for athletic use. This study aimed to investigate the restraining force of the elastomeric brace and compare it with that of functional and soft braces.

Methods

A custom-made anterior displacement knee model was used. The restraining force of the elastomeric, functional, and soft braces against 20 mm of anterior tibial displacement was measured in five sets of five repetitions using a tensile testing machine directly connected to the knee model.

Findings

The elastomeric knee brace demonstrated a higher restraining force at all displacements than the functional and soft knee braces, particularly in the initial phase (0–10 mm). The decrease in the restraining force over repeated trials was less pronounced at 5- and 10-mm displacements, indicating that the elastomeric knee brace maintained a more stable restraining force.

Interpretation

The developed elastomeric knee brace exerted a higher restraining force against anterior tibial displacement than the functional and soft knee braces, and this restraining effect was maintained even after repeated use.

背景：膝关节支架常用于前交叉韧带缺乏的膝关节。虽然刚性功能膝托仅限于某些接触性运动，但软膝托几乎可以用于所有运动。然而，关于膝关节软托的抑制作用的研究很少。我们开发了一种具有解剖带和无刚性铰链的弹性膝关节支架，以提高其运动使用的适用性。本研究旨在探讨弹性支架的约束力，并将其与功能性和软质支架进行比较。方法：采用定制的膝关节前移位模型。使用与膝关节模型直接相连的拉力试验机，测量了弹性支架、功能性支架和软支架对胫骨前移位20mm的抑制力，每组5次重复。研究结果：弹性膝托比功能性和软性膝托具有更高的约束力，特别是在初始阶段（0-10 mm）。在重复试验中，在5毫米和10毫米的位移中，约束力的下降不太明显，这表明弹性膝托保持了更稳定的约束力。结论：与功能性和软性膝关节支架相比，开发的弹性膝关节支架对胫骨前移位具有更高的抑制力，并且即使在重复使用后也能保持这种抑制效果。

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引用次数: 0

Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults 基于上肢和下肢加速度计的步态指标作为老年人身体功能的预测指标。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.clinbiomech.2026.106774

Takahiro Oki , Keiko Yamada , Shigeru Nada , Ryoki Nishimoto , Sayaka Fujiwara , Toru Ogata

Background

Physical function and activities of daily living (ADLs) are key determinants of independence in older adults, with walking being an essential component of ADLs. Gait assessment using multiple sensors may enable early detection of functional decline and cause-specific intervention. We hypothesized that specific accelerometer-based gait metrics from both the upper and lower trunk sensors are associated with declining mobility in older adults.

Methods

Gait analysis was conducted in community-dwelling older adults with declining mobility using accelerometers attached to the upper and lower trunk. Physical function was evaluated using the five-repetition sit-to-stand test, single-leg standing time, three-meter Timed Up and Go test, preferred gait speed, and the locomotive syndrome risk test. Associations between physical performance and accelerometer-based metrics were examined using correlation, regression, and principal component analyses.

Findings

Gait speed correlated strongly with Root Mean Square (RMS)-vertical (VT) and with several performance metrics. Upper RMS-VT, upper improved Harmonic Ratio in the anteroposterior direction (iHR-AP), upper iHR-VT, lower iHR-AP, and the upper/lower trunk RMS ratio in the mediolateral direction ([U/L] RMS ratio-ML) associated with performance metrics. After adjustment for age, sex, and gait speed, upper and lower iHR-AP and upper iHR-VT remained associated (p < 0.05). Principal component analysis indicated that principal component 1, which was correlated with gait speed, included RMS-VT, whereas iHRs belonged to a different component.

Interpretation

Accelerometer-based metrics obtained from both the upper and lower trunk reflect physical function and may serve as indicators of early gait impairment, as well as for future interventional studies.

背景：身体功能和日常生活活动（ADLs）是老年人独立性的关键决定因素，步行是ADLs的重要组成部分。使用多个传感器进行步态评估可能有助于早期发现功能衰退和病因特异性干预。我们假设，来自上、下躯干传感器的基于加速度计的特定步态指标与老年人活动能力下降有关。方法：使用附着在上肢和下肢的加速度计对社区居住的行动能力下降的老年人进行步态分析。采用5次重复坐立测试、单腿站立时间、3米Timed Up and Go测试、首选步态速度和机车综合征风险测试来评估身体功能。使用相关性、回归和主成分分析检查了物理性能和基于加速度计的指标之间的关联。研究结果：步态速度与均方根(RMS)-垂直（VT）和几个性能指标密切相关。上RMS- vt、正位方向上改善谐波比（iHR-AP）、上iHR-VT、下iHR-AP和中外侧方向上/下主干RMS比（[U/L] RMS比- ml）与表现指标相关。在调整了年龄、性别和步态速度后，上、下iHR-AP和上iHR-VT仍然相关(p解释：从上、下躯干获得的基于加速度计的指标反映了身体功能，可以作为早期步态障碍的指标，以及未来的介入研究。

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引用次数: 0

Predicting gait kinetics using 3-degrees of freedom acceleration data and artificial neural networks 利用三自由度加速度数据和人工神经网络预测步态动力学

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.clinbiomech.2026.106775

Carina Gempfer , Gilmar F. Santos , Alexander Hobein , Timo Kuhlgatz , Christof Hurschler , Eike Jakubowitz

Background

Motion analysis plays an important role in clinical decision-making and biomechanical research. Conventional assessments rely on laboratory-based motion capture and force plates, which are accurate but resource-intensive. Wearable sensors combined with artificial neural networks offer a promising alternative for use outside the laboratory, but they must be validated against established systems. The aim of this study was to predict important kinetic gait parameters, such as ground reaction forces, knee joint moments and knee power, using wearable sensors and neural networks. Such an approach may support gait assessment in orthopaedic conditions and enable more responsive adjustment of exoprostheses.

Methods

Thirty-two healthy adults provided informed consent and were instrumented. Standard kinematic and kinetic data were captured using a conventional motion analysis setup, while linear accelerations were recorded synchronously using wearable sensors. These acceleration signals were used as inputs for two neural network models (long short-term memory and multilayer perceptron) to predict kinetic parameters.

Findings

Both models achieved good to very good agreement with the reference system. Pearson correlation coefficients ranged from 0.79 for the knee joint power to 0.99 for anteroposterior ground reaction force. The normalised root mean square errors between 3.1% and 10.3% further demonstrated promising predictive accuracy.

Interpretation

The findings indicate that wearable sensors combined with neural networks can estimate clinically relevant kinetic gait parameters with high accuracy outside a laboratory setting. In the future, such predictions may help standardize dynamic adjustments of exoprostheses, support the diagnosis of orthopaedic conditions and evaluate treatment outcomes.

背景运动分析在临床决策和生物力学研究中发挥着重要作用。传统的评估依赖于基于实验室的动作捕捉和力板，这是准确的，但资源密集。与人工神经网络相结合的可穿戴传感器为实验室外的使用提供了一种很有前途的替代方案，但它们必须在现有系统中进行验证。本研究的目的是利用可穿戴传感器和神经网络预测重要的动力学步态参数，如地面反作用力、膝关节力矩和膝关节力量。这种方法可以支持骨科条件下的步态评估，并使外假体的调整更加灵敏。方法32名健康成人提供知情同意并进行仪器检查。使用传统的运动分析装置捕获标准的运动学和动力学数据，同时使用可穿戴传感器同步记录线性加速度。将这些加速度信号作为两个神经网络模型（长短期记忆和多层感知器）的输入来预测动力学参数。结果两种模型都与参考系统达到了很好的一致性。Pearson相关系数从膝关节力量的0.79到前后地面反作用力的0.99不等。归一化均方根误差在3.1%至10.3%之间，进一步证明了有希望的预测准确性。研究结果表明，结合神经网络的可穿戴传感器可以在实验室环境之外以高精度估计临床相关的动力学步态参数。在未来，这些预测可能有助于规范外假体的动态调整，支持骨科疾病的诊断和评估治疗结果。

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引用次数: 0

Micromotion at a femoral osteotomy stabilized with a retrograde interlocking intramedullary nail 用逆行交锁髓内钉稳定股骨截骨术中的微动

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clinbiomech.2026.106749

Rachel L. Lenhart , Mei Wang , Gregory J. Schmeling

Background

Retrograde nails are becoming used increasingly in the trauma setting and the indications are expanding. The goal of this study was to evaluate micromotion at fracture sites in the proximal half of the femur stabilized with a retrograde intramedullary nail to determine the effects of fracture location, canal fill, and screw configuration.

Methods

Composite femurs were loaded in simulated single-leg stance while measurements of micromotion were made using linear variable differential transducers and motion analysis. Part one of the study compared differences by fracture location (subtrochanteric vs. proximal third vs. mid-shaft). Part two determined the effects of canal fill (13 vs. 10 mm nail) and proximal interlocking screw configuration on micromotion in the setting of subtrochanteric fracture.

Findings

Subtrochanteric fracture location led to significantly more axial displacement compared to the other locations (p < 0.05). Reduced canal fill led to more coronal rotation (p < 0.05) and likely more axial displacement (p = 0.06). Screw configuration was important for axial displacement (p < 0.05), particularly in the non-canal filling condition where the proximal screw configuration with only one screw in the more proximal location had increased micromotion compared to one distal.

Interpretation

Fracture location, nail size, and proximal locking screw configuration are all important to the stability of the fracture construct. In subtrochanteric fractures, surgeons should consider using a canal filling nail with either two screws or the distal screw only, or using a different nail design.

背景：逆行钉在创伤治疗中的应用越来越广泛，适应症也在不断扩大。本研究的目的是评估用逆行髓内钉固定股骨近端骨折部位的微运动，以确定骨折位置、管填充和螺钉配置的影响。方法以模拟单腿站立方式加载复合股骨，采用线性可变差分传感器测量微动，并进行运动分析。研究的第一部分比较了骨折位置的差异（转子下、第三近端和中轴）。第二部分确定了粗隆下骨折情况下，管内填充（13和10毫米钉）和近端互锁螺钉配置对微动的影响。结果股骨粗隆下骨折位置导致轴向移位明显多于其他位置（p < 0.05）。椎管充填减少导致更多的冠状旋转（p < 0.05）和可能更多的轴向位移（p = 0.06）。螺钉配置对轴向位移很重要（p < 0.05），特别是在非根管填充的情况下，与远端相比，近端只有一颗螺钉的近端螺钉配置增加了微动。骨折位置、钉的大小和近端锁定螺钉的配置对骨折结构的稳定性都很重要。对于粗隆下骨折，外科医生应考虑使用带两枚螺钉的管内填充钉或仅使用远端螺钉，或使用不同设计的钉。

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引用次数: 0

Threshold screw insertion torque for carbon fibre-reinforced polyetheretherketone and titanium (Ti-6Al-4V) locking plate constructs 碳纤维增强聚醚醚酮和钛（Ti-6Al-4V）锁定板结构的阈值螺钉插入扭矩。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.clinbiomech.2026.106769

Ramzi Nasr , Elise Pegg , Fedra Zaribaf , James Fletcher

Background

Locking plate constructs are integral to modern fracture fixation, particularly in osteoporotic bone. Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates offer a stiffness profile closer to cortical bone than titanium, potentially improving the mechanical environment for healing. However, the optimal insertion torque for locking screws in CFR-PEEK plates is unclear. This study investigated the influence of insertion torque on construct performance in CFR-PEEK plates compared to titanium alloy (Ti-6Al-4V) plates.

Methods

Locking screws (3.5 mm, Ti-6Al-4V) were inserted into Ti-6Al-4V and CFR-PEEK plates at six torque levels (0.5–3.0 Nm). Construct strength was assessed via axial push-out and cantilever bending tests. Video analysis was used to correlate insertion torque with screw rotation. Additional testing was performed on two-screw CFR-PEEK constructs at three torque levels (0.5, 1.5, 2.5 Nm).

Findings

Insertion torque was linearly related to screw rotation within the tested range (0.5–3.0 Nm). In CFR-PEEK single screw constructs, higher torque (≥2 Nm) improved push-out strength (p < 0.05), while 1.5 Nm yielded the highest cantilever strength (p < 0.05). Ti-6Al-4V constructs showed a similar trend. In two-screw CFR-PEEK constructs, no significant differences were found in performance across torques for either push-out or cantilever testing (p > 0.5).

Interpretation

Beyond an initial threshold (∼0.5 Nm), increased insertion torque did not consistently enhance construct performance. These findings indicate that moderate torques (∼1.5 Nm) optimise performance while reducing the risk of implant damage, support the mechanical reliability of CFR-PEEK plates.

背景：锁定钢板结构在现代骨折固定中是不可或缺的，特别是在骨质疏松的骨骼中。碳纤维增强聚醚醚酮（CFR-PEEK）板提供比钛更接近皮质骨的刚度轮廓，潜在地改善愈合的机械环境。然而，锁定螺钉在CFR-PEEK板中的最佳插入扭矩尚不清楚。本研究比较了插入扭矩对CFR-PEEK板与钛合金（Ti-6Al-4V）板结构性能的影响。方法：将锁定螺钉（3.5 mm, Ti-6Al-4V）以6个扭矩水平（0.5 ~ 3.0 Nm）插入Ti-6Al-4V和CFR-PEEK板中。通过轴向推出和悬臂弯曲试验评估结构强度。使用视频分析将插入力矩与螺杆旋转相关联。在三个扭矩水平（0.5,1.5,2.5 Nm）下对双螺钉CFR-PEEK结构进行了额外的测试。结果：在测试范围内（0.5-3.0 Nm），插入扭矩与螺钉旋转呈线性相关。在CFR-PEEK单螺钉结构中，更高的扭矩（≥2 Nm）提高了推出强度（p 0.5）。解释：超过初始阈值（~ 0.5 Nm）后，插入扭矩的增加并不能持续提高构建体的性能。这些发现表明，适度的扭矩（~ 1.5 Nm）可以优化性能，同时降低植入物损伤的风险，支持CFR-PEEK板的机械可靠性。

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引用次数: 0

The impact of age on muscle and kinematic responses following an unpredictable forward slip while walking 年龄对行走时不可预测的前滑后肌肉和运动学反应的影响。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.clinbiomech.2026.106779

Steven Phu , Daina L. Sturnieks , Stephen R. Lord , Yoshiro Okubo

Background

Slips lead to many falls in older adults. This study aimed to determine the impact of age on muscle and kinematic responses following an unpredictable forward slip while walking.

Methods

A cross-sectional study was conducted with 127 adults (25 young and 102 older) exposed to a single unpredictable forward slip, induced at foot-strike while walking. Bilateral lower limb muscle activity was measured via electromyography and gait kinematics were measured via motion capture.

Findings

Compared to young, older adults displayed greater relative muscle activity and higher relative centre of mass during walking prior to the slip onset (P < 0.05). Following the slip, older adults experienced slips with greater velocity, displayed longer muscle onset latency and time to peak activity of the hamstrings on the non-slipped (contralateral) limb and greater peak activity magnitudes of the gastrocnemius bilaterally (P < 0.05). Older adults also spent more time in double-limb stance (P = 0.001), took a slower second recovery step (P = 0.006), and displayed greater harness loading (P = 0.005).

Interpretation

Older adults had inferior muscle and kinematic responses to an unpredictable forward slip compared to young. Delayed activation of the contralateral limb knee flexors and hip extensors may lead to greater instability, more severe slips and an increased risk of falls in older adults.

背景：滑倒导致许多老年人跌倒。本研究旨在确定年龄对行走时不可预测的前滑后肌肉和运动学反应的影响。方法：一项横断面研究对127名成年人（25名年轻人和102名老年人）进行了研究，这些成年人在走路时受到一次不可预测的前滑，这是由脚撞击引起的。通过肌电图测量双侧下肢肌肉活动，通过运动捕捉测量步态运动学。研究结果：与年轻人相比，老年人在滑倒发生前的行走中表现出更大的相对肌肉活动和更高的相对质量中心(P解释：与年轻人相比，老年人对不可预测的前滑的肌肉和运动学反应较差。延迟激活对侧肢体膝关节屈肌和髋关节伸肌可能导致更大的不稳定，更严重的滑倒和老年人跌倒的风险增加。

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引用次数: 0

Mechanical equilibrium of the ankle joint: Implications for Achilles tendon injury. 踝关节的机械平衡：对跟腱损伤的影响。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-03-19 DOI: 10.1016/j.clinbiomech.2026.106827

Ra''ad M Khair, Afet Mustafaoglu, Yu Chou Lin, Maria Sukanen, Taija Finni

Background: A longer Achilles tendon (AT) moment arm (MA) relative to the foot length requires less muscle force for a given plantarflexion moment, thereby lowering mechanical load on the tendon. We examined whether the AT and foot MA lengths in healthy (N = 28) differ from height and body mass matched individuals with AT tendinopathy (N = 28) and rupture (N = 29). We hypothesized that a longer AT MA has a protective effect on tendon loading with the patient groups having smaller MA compared to asymptomatic individuals.

Methods: MAs were assessed using 2-D image-based method. AT MA was defined as the shortest distance from the centre line of action of the AT to the line between malleoli. Ratio of ankle lever was calculated by dividing AT by Foot MAs.

Findings: AT MA was longer in healthy than either the tendinopathy (mean difference 3.86 mm, p = 0.02) or rupture group (5.41 mm, p < 0.001). Foot MA was not statistically different between the groups (p = 0.06). Ratio of ankle lever differed between groups with the healthy group showing higher ratio compared to both the tendinopathy group (0.04, p = 0.001), and the rupture group (0.06, p < 0.001). AT and Foot MAs correlated with body mass and height, whereas the ratio of ankle lever did not.

Interpretation: A longer AT relative to foot MA length may improve the tendon's safety factor by reducing mechanical stress. This ratio may serve as an accessible intrinsic risk factor for AT injuries, even when assessed only using simple 2-D anatomical measures.

背景：相对于足长较长的跟腱（AT）力臂（MA）在给定的跖屈力矩下需要较少的肌肉力，从而降低肌腱的机械负荷。我们检查了健康（N = 28）的AT和足部MA长度是否与身高和体重匹配的AT肌腱病变（N = 28）和断裂（N = 29）个体不同。我们假设，与无症状个体相比，具有较小MA的患者组具有较长AT MA对肌腱负荷的保护作用。方法：采用基于二维图像的方法对MAs进行评估。AT MA定义为AT的作用中心线到malleoli间线的最短距离。踝关节杠杆比率由AT除以足部MAs计算。结果：健康组AT MA比肌腱病变组（平均差3.86 mm, p = 0.02）或断裂组（5.41 mm, p）更长。解释：相对于足部MA长度较长的AT可能通过减少机械应力来提高肌腱的安全系数。即使仅使用简单的二维解剖测量来评估，该比率也可作为AT损伤的可获得的内在危险因素。

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引用次数: 0

The effect of low muscle mass on neck disorder and cervical movement kinematics in university students: A comparative study. 低肌肉量对大学生颈部疾病和颈椎运动运动学的影响：一项比较研究。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2026-03-18 DOI: 10.1016/j.clinbiomech.2026.106825

Minghe Yao, Lingxian Zhong, Zhijun Li, Yingbo Xu, Tingkui Wu, Kangkang Huang, Shihao Chen, Xiaoqiang Zhao, Yi Deng, Beiyu Wang

Background: Skeletal muscle mass correlates with spinal health. While a consistent prevalence of low muscle mass has been observed in young adults, its impact on neck health remained unclear. The study aims to compare cervical kinematics during rapid movements and neck symptoms between university student groups with low or normal muscle mass.

Methods: This was a cross-sectional study. From May to July 2024, cervical kinematic performance and body composition were measured in college students aged 18-24. Kinematic data was collected using a virtual reality system. Parameters included the range of neck motion, peak velocity, peak acceleration, and normalized jerk index. Bioelectrical impedance analysis measured body weight, skeletal muscle mass, and other body components. Skeletal muscle mass index (SMI) was calculated as the percentage of skeletal muscle mass in body weight. The Neck Pain and Disability Scale (NPAD) was assessed.

Findings: Data from 100 participants were analyzed. Low muscle mass was detected in 18 participants (18%). Low muscle mass group had a higher NPAD score (p = 0.028). Peak velocity and peak acceleration were significantly lower in low muscle mass group only during neck extension (p < 0.001). On multiple linear regression analysis, SMI, age and height were significantly associated with both peak velocity and peak acceleration.

Interpretation: University students with low muscle mass exhibited altered cervical kinematics only during extension movements, accompanied by more neck pain and disability. This study provides evidence of the relationship of muscle mass and cervical spine health in early adulthood.

背景：骨骼肌质量与脊柱健康相关。虽然在年轻人中观察到低肌肉量的普遍存在，但其对颈部健康的影响尚不清楚。该研究旨在比较肌肉量低或正常的大学生群体在快速运动时的颈椎运动学和颈部症状。方法：采用横断面研究。从2024年5月到7月，测量了18-24岁大学生的颈椎运动性能和身体成分。利用虚拟现实系统收集运动数据。参数包括颈部运动范围、峰值速度、峰值加速度和归一化抽搐指数。生物电阻抗分析测量了体重、骨骼肌质量和其他身体成分。骨骼肌质量指数（SMI）计算为骨骼肌质量占体重的百分比。颈部疼痛和残疾量表（NPAD）进行评估。研究结果：对100名参与者的数据进行了分析。在18名参与者（18%）中检测到低肌肉量。低肌量组NPAD评分较高（p = 0.028）。解释：低肌肉量的大学生仅在颈部伸展运动中表现出颈部运动学改变，并伴有更多的颈部疼痛和残疾。这项研究为成年早期肌肉质量与颈椎健康的关系提供了证据。

{"title":"The effect of low muscle mass on neck disorder and cervical movement kinematics in university students: A comparative study.","authors":"Minghe Yao, Lingxian Zhong, Zhijun Li, Yingbo Xu, Tingkui Wu, Kangkang Huang, Shihao Chen, Xiaoqiang Zhao, Yi Deng, Beiyu Wang","doi":"10.1016/j.clinbiomech.2026.106825","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106825","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle mass correlates with spinal health. While a consistent prevalence of low muscle mass has been observed in young adults, its impact on neck health remained unclear. The study aims to compare cervical kinematics during rapid movements and neck symptoms between university student groups with low or normal muscle mass.</p><p><strong>Methods: </strong>This was a cross-sectional study. From May to July 2024, cervical kinematic performance and body composition were measured in college students aged 18-24. Kinematic data was collected using a virtual reality system. Parameters included the range of neck motion, peak velocity, peak acceleration, and normalized jerk index. Bioelectrical impedance analysis measured body weight, skeletal muscle mass, and other body components. Skeletal muscle mass index (SMI) was calculated as the percentage of skeletal muscle mass in body weight. The Neck Pain and Disability Scale (NPAD) was assessed.</p><p><strong>Findings: </strong>Data from 100 participants were analyzed. Low muscle mass was detected in 18 participants (18%). Low muscle mass group had a higher NPAD score (p = 0.028). Peak velocity and peak acceleration were significantly lower in low muscle mass group only during neck extension (p < 0.001). On multiple linear regression analysis, SMI, age and height were significantly associated with both peak velocity and peak acceleration.</p><p><strong>Interpretation: </strong>University students with low muscle mass exhibited altered cervical kinematics only during extension movements, accompanied by more neck pain and disability. This study provides evidence of the relationship of muscle mass and cervical spine health in early adulthood.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"136 ","pages":"106825"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0