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Medial and Lateral Tibiofemoral Compressive Forces in Patients Following Unilateral Total Knee Arthroplasty During Stationary Cycling. 固定循环期间单侧全膝关节置换术后患者的胫股内侧和外侧压缩力。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-05-19 DOI: 10.1123/jab.2020-0324
Erik T. Hummer, Tanner A. Thorsen, Joshua T. Weinhandl, J. Reinbolt, H. Cates, Songning Zhang
Patients following unilateral total knee arthroplasty (TKA) display interlimb differences in knee joint kinetics during gait and more recently, stationary cycling. The purpose of this study was to use musculoskeletal modeling to estimate total, medial, and lateral tibiofemoral compressive forces for patients following TKA during stationary cycling. Fifteen patients of unilateral TKA, from the same surgeon, participated in cycling at 2 workrates (80 and 100 W). A knee model (OpenSim 3.2) was used to estimate total, medial, and lateral tibiofemoral compressive forces for replaced and nonreplaced limbs. A 2 × 2 (limb × workrate) and a 2 × 2 × 2 (compartment × limb × workrate) analysis of variance were run on the selected variables. Peak medial tibiofemoral compressive force was 23.5% lower for replaced compared to nonreplaced limbs (P = .004, G = 0.80). Peak medial tibiofemoral compressive force was 48.0% greater than peak lateral tibiofemoral compressive force in nonreplaced limbs (MD = 344.5 N, P < .001, G = 1.6) with no difference in replaced limbs (P = .274). Following TKA, patients have greater medial compartment loading on their nonreplaced compared to their replaced limbs and ipsilateral lateral compartment loading. This disproportionate loading may be cause for concern regarding exacerbating contralateral knee osteoarthritis.
单侧全膝关节置换术(TKA)后的患者在步态和最近的固定自行车运动中,膝关节动力学表现出四肢间差异。本研究的目的是使用肌肉骨骼模型来估计TKA患者在静止循环中的总、内侧和外侧胫股压缩力。来自同一外科医生的15名单侧TKA患者以2种工作率(80和100W)参与了自行车运动。膝关节模型(OpenSim 3.2)用于估计更换和未更换肢体的胫股总压力、内侧压力和外侧压力。对所选变量进行2×2(肢×工作率)和2×2。与未置换肢体相比,置换肢体的胫股内侧峰值压缩力低23.5%(P=0.004,G=0.80)。未置换肢体的胫骨股内侧峰值压力比胫骨股外侧峰值压缩力高48.0%(MD=344.5N,P<.001,G=1.6),置换肢体无差异(P=.274)。TKA后,与被替换的肢体和同侧外侧隔室负荷相比,患者在未被替换的四肢上具有更大的内侧隔室负荷。这种不成比例的负荷可能会加剧对侧膝关节骨性关节炎。
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引用次数: 1
Characterizing Lumbar Spine Kinematics and Kinetics During Simulated Low-Speed Rear Impact Collisions. 模拟低速后碰撞时腰椎运动学和动力学特征。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-05-17 DOI: 10.1123/jab.2021-0189
K. Fewster, Jackie D. Zehr, Chad E. Gooyers, R. Parkinson, J. Callaghan
BACKGROUNDRecent work has demonstrated that low back pain is a common complaint following low-speed collisions. Despite frequent pain reporting, no studies involving human volunteers have been completed to examine the exposures in the lumbar spine during low-speed rear impact collisions.METHODSTwenty-four participants were recruited and a custom-built crash sled simulated rear impact collisions, with a change in velocity of 8 km/h. Randomized collisions were completed with and without lumbar support. Inverse dynamics analyses were conducted, and outputs were used to generate estimates of peak L4/L5 joint compression and shear.RESULTSAverage (SD) peak L4/L5 compression and shear reaction forces were not significantly different without lumbar support (compression = 498.22 N [178.0 N]; shear = 302.2 N [98.5 N]) compared to with lumbar support (compression = 484.5 N [151.1 N]; shear = 291.3 N [176.8 N]). Lumbar flexion angle at the time of peak shear was 36° (12°) without and 33° (11°) with lumbar support.CONCLUSIONOverall, the estimated reaction forces were 14% and 30% of existing National Institute of Occupational Safety and Health occupational exposure limits for compression and shear during repeated lifting, respectively. Findings also demonstrate that, during a laboratory collision simulation, lumbar support does not significantly influence the total estimated L4/L5 joint reaction force.
背景最近的研究表明,腰痛是低速碰撞后的常见症状。尽管经常有疼痛报告,但尚未完成涉及人类志愿者的研究,以检查低速后部碰撞过程中腰椎的暴露情况。方法招募了四名参与者,并用一个定制的撞击雪橇模拟后部碰撞,速度变化为8km/h。随机碰撞是在有和没有腰部支撑的情况下完成的。进行了反向动力学分析,并将输出用于生成L4/L5节理压缩和剪切峰值的估计值。结果L4/L5的平均峰值压缩和剪切反作用力(SD)在没有腰部支撑的情况下(压缩=498.22 N[178.0 N];剪切=302.2 N[98.5 N])与有腰部支撑的(压缩=484.5 N[151.1 N];剪切=291.3 N[176.8 N])没有显著差异。峰值剪切时,没有腰部支撑时的腰椎屈曲角度为36°(12°),有腰部支撑时为33°(11°)。结论总体而言,在重复提升过程中,估计的反作用力分别为美国国家职业安全与健康研究所现有压缩和剪切职业接触限值的14%和30%。研究结果还表明,在实验室碰撞模拟过程中,腰部支撑不会显著影响L4/L5关节的总反作用力。
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引用次数: 1
Lower Limb Extension Power is Associated With Slope Walking Joint Loading Mechanics in Older Adults. 老年人下肢伸展力与斜坡行走关节负荷力学有关。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-05-06 DOI: 10.1123/jab.2021-0342
Peter B Thomsen, Jacob W Aumeier, Chelsey A Wilbur, Evan G. Oro, Hunter B. Carlson, Jesse C. Christensen
Fall-related injuries are associated with muscle weakness and common during slope walking in older adults. However, no study has evaluated the relationship between muscle weakness, measured by maximal lower limb extension power, and older adults' ability to navigate slope walking for a better understanding of fall prevention. Therefore, the purpose of this study was to investigate the association between maximal lower limb extension power and joint mechanics during slope walking. Fifteen healthy older adults were tested. Lower limb extension power was measured using the Leg Extension Power Rig. Kinematic and kinetic analysis was performed during level (0°), incline (10°), and decline (10°) slope walking. Greater maximal lower limb extension power was significantly (p < .050; Cohen's f2 > 0.35) associated with multiple kinetic and kinematic joint mechanic variables across stance phase of the gait cycle during level, incline, and decline walking. These findings will allow clinicians to better educate patients and develop interventions focused on fall prevention and improving functional mobility in older adults.
跌倒相关损伤与肌肉无力有关,在老年人斜坡行走中很常见。然而,没有研究评估肌肉无力(以最大下肢伸展力衡量)与老年人斜坡行走能力之间的关系,以便更好地了解预防跌倒的方法。因此,本研究的目的是探讨斜坡行走时下肢最大伸展力与关节力学之间的关系。对15名健康的老年人进行了测试。下肢伸展力采用伸腿力仪测量。在水平(0°)、倾斜(10°)和下降(10°)斜坡行走期间进行运动学和动力学分析。下肢最大伸展力显著增加(p < 0.05);Cohen's f2 > 0.35)与水平、倾斜和下降行走过程中步态周期的站立阶段的多个动力学和运动学关节力学变量相关。这些发现将允许临床医生更好地教育患者,并制定干预措施,重点是预防跌倒和改善老年人的功能活动能力。
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引用次数: 0
Head Impact Kinematics and Brain Deformation in Paired Opposing Youth Football Players. 配对对抗青少年足球运动员头部碰撞运动学与脑变形。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-28 DOI: 10.1123/jab.2021-0098
Gabriella M Milef, L. Miller, Daniella M DiGuglielmo, Tanner D Payne, Tanner M. Filben, J. Urban, Joel Stitzel
Head impact exposure is often quantified using peak resultant kinematics. While kinematics describes the inertial response of the brain to impact, they do not fully capture the dynamic brain response. Strain, a measure of the tissue-level response of the brain, may be a better predictor of injury. In this study, kinematic and strain metrics were compared to contact characteristics in youth football. Players on 2 opposing teams were instrumented with head impact sensors to record impact kinematics. Video was collected to identify contact scenarios involving opposing instrumented players (ie, paired contact scenarios) and code contact characteristics (eg, player role, impact location). A previously validated, high-resolution brain finite element model, the atlas-based brain model, was used to simulate head impacts and calculate strain metrics. Fifty-two paired contact scenarios (n = 105 impacts) were evaluated. Lighter players tended to have greater biomechanical metrics compared to heavier players. Impacts to the top of the helmet were associated with lower strain metrics. Overall, strain was better correlated with rotational kinematics, suggesting these metrics may be better predictors of the tissue-level brain response than linear kinematics. Understanding the effect of contact characteristics on brain strain will inform future efforts to improve sport safety.
头部撞击暴露通常用峰值合成运动学来量化。虽然运动学描述了大脑对撞击的惯性反应,但它们并没有完全捕捉到大脑的动态反应。应变是衡量大脑组织水平反应的一种指标,可能是更好的损伤预测指标。在这项研究中,运动学和应变指标与青少年足球的接触特性进行了比较。两支对立球队的球员都配备了头部撞击传感器,以记录撞击的运动学。收集视频以确定涉及对方仪器球员的接触场景(即配对接触场景)和代码接触特征(例如,球员角色,撞击位置)。先前验证的高分辨率大脑有限元模型,即基于atlas的大脑模型,用于模拟头部撞击并计算应变指标。评估了52个配对接触情景(n = 105个影响)。与较重的玩家相比,较轻的玩家往往拥有更大的生物力学指标。对头盔顶部的冲击与较低的应变指标相关。总的来说,应变与旋转运动学的相关性更好,这表明这些指标可能比线性运动学更好地预测组织水平的大脑反应。了解接触特性对脑劳损的影响将为今后提高运动安全提供信息。
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引用次数: 2
Gait Slip-Induced Fall-Type Assessment Based on Regular Gait Characteristics in Older Adults. 基于老年人常规步态特征的步态滑倒型评估。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-28 DOI: 10.1123/jab.2021-0337
Shuaijie Wang, Y. Pai, T. Bhatt
Older adults could experience split falls or feet-forward falls following an unexpected slip in gait due to different neuromuscular vulnerabilities, and different intervention strategies would be required for each type of faller. Thus, this study aimed to investigate the key factors affecting the fall types based on regular gait pattern. A total of 105 healthy older adults who experienced a laboratory-induced slip and fall were included. Their natural walking trial immediately prior to the novel slip trial was analyzed. To identify the factors related to fall type, gait characteristics and demographic factors were determined using univariate logistic regression, and then stepwise logistic regression was conducted to assess the slip-induced fall type based on these factors. The best fall-type prediction model involves gait speed and recovery foot angular velocity, which could predict 70.5% of feet-forward falls and 86.9% of split falls. Body mass index was also a crucial fall-type prediction with an overall prediction accuracy of 70.5%. Along with gait parameters, 84.1% of feet-forward falls and 78.7% of split falls could be predicted. The findings in this study revealed the determinators related to fall types, which enhances our knowledge of the mechanism associated to slip-induced fall and would be helpful for the development of tailored interventions for slip-induced fall prevention.
由于不同的神经肌肉脆弱性,老年人可能会在意外的步态滑倒后经历分裂跌倒或脚向前跌倒,每种类型的跌倒需要不同的干预策略。因此,本研究旨在探讨在正常步态模式下影响跌倒类型的关键因素。共有105名健康老年人经历了实验室诱发的滑倒和跌倒。他们的自然行走试验,立即之前的新滑动试验进行分析。为确定与跌倒类型相关的因素,采用单变量logistic回归确定步态特征和人口学因素,并基于这些因素进行逐步logistic回归评估滑倒类型。最佳的跌倒类型预测模型包括步态速度和恢复足角速度,对足前跌倒的预测率为70.5%,对劈腿跌倒的预测率为86.9%。身体质量指数也是预测跌倒类型的关键指标,总体预测准确率为70.5%。结合步态参数,可以预测84.1%的前足跌倒和78.7%的劈开跌倒。本研究的发现揭示了与跌倒类型相关的决定因素,这增强了我们对滑倒相关机制的认识,并有助于制定针对性的预防滑倒干预措施。
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引用次数: 0
Can Increased Locomotor Task Difficulty Differentiate Knee Muscle Forces After Anterior Cruciate Ligament Reconstruction? 前交叉韧带重建后运动任务难度的增加能否区分膝关节肌肉力量?
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-01 DOI: 10.1123/jab.2021-0215
Megan J Schroeder, Samuel A Acuña, Chandramouli Krishnan, Yasin Y Dhaher

Changes in knee mechanics following anterior cruciate ligament (ACL) reconstruction are known to be magnified during more difficult locomotor tasks, such as when descending stairs. However, it is unclear if increased task difficulty could distinguish differences in forces generated by the muscles surrounding the knee. This study examined how knee muscle forces differ between individuals with ACL reconstruction with different graft types (hamstring tendon and patellar tendon autograft) and "healthy" controls when performing tasks with increasing difficulty. Dynamic simulations were used to identify knee muscle forces in 15 participants when walking overground and descending stairs. The analysis was restricted to the stance phase (foot contact through toe-off), yielding 162 separate simulations of locomotion in increasing difficulty: overground walking, step-to-floor stair descent, and step-to-step stair descent. Results indicated that knee muscle forces were significantly reduced after ACL reconstruction, and stair descent tasks better discriminated changes in the quadriceps and gastrocnemii muscle forces in the reconstructed knees. Changes in quadriceps forces after a patellar tendon graft and changes in gastrocnemii forces after a hamstring tendon graft were only revealed during stair descent. These results emphasize the importance of incorporating sufficiently difficult tasks to detect residual deficits in muscle forces after ACL reconstruction.

前交叉韧带(ACL)重建后的膝关节力学变化在更困难的运动任务中被放大,例如下楼梯。然而,目前尚不清楚增加的任务难度是否能区分膝盖周围肌肉产生的力的差异。本研究考察了采用不同移植类型(腘绳肌腱和髌骨肌腱自体移植)重建前交叉韧带的个体与“健康”对照者在执行难度增加的任务时膝关节肌肉力量的差异。动态模拟用于识别15名参与者在地上行走和下楼梯时膝盖肌肉的力量。分析仅限于站立阶段(脚部通过脚趾接触),产生162个不同难度的运动模拟:地上行走、台阶到楼梯下降和台阶到楼梯下降。结果表明,前交叉韧带重建后膝关节肌力明显降低,楼梯下降任务能更好地识别重建膝关节四头肌和腓肠肌肌力的变化。髌骨肌腱移植后股四头肌力量的变化和腘绳肌腱移植后腓肠肌力量的变化仅在楼梯下降时显示。这些结果强调了纳入足够困难的任务来检测前交叉韧带重建后肌肉力量残留缺陷的重要性。
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引用次数: 1
Erratum: Kawakami et al (2019). 勘误:Kawakami et al(2019)。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-01 DOI: 10.1123/jab.2022-0012

In the article Kawakami W, Takahashi M, Iwamoto Y, Shinkoda K. Coordination among shank, rearfoot, midfoot, and forefoot kinematic movement during gait in individuals with hallux valgus. J Appl Biomech. 2019;35(1):44–51, https://doi.org/10.1123/jab.2017-0319, an author name was spelled incorrectly. Koichi Shinkoda was spelled Koichi Shinakoda. The online version of this article has been corrected.

Kawakami W, Takahashi M, Iwamoto Y, Shinkoda K.拇外翻患者步态中小腿、后足、中足和前足运动的协调性。苹果生物科技学报,2019;35(1):44-51,https://doi.org/10.1123/jab.2017-0319,作者姓名拼写错误。Koichi Shinkoda的拼写是Koichi Shinakoda。本文的在线版本已被更正。
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引用次数: 0
Shoulder Kinesio Taping Does Not Change Biomechanical Deficits Associated With Scapular Dyskinesis. 肩胛骨运动功能不良不能改变肩胛骨运动障碍相关的生物力学缺陷。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-01 DOI: 10.1123/jab.2021-0259
Sevgi Sevi Yeşilyaprak, Ertuğrul Yüksel, Melike Gizem Kalaycı, Nuri Karabay, Lori A Michener

Observable scapular dyskinesis is associated with biomechanical deficits. Preventative interventions aimed at correcting these deficits may aid in preventing the development and resolution of shoulder pain. Our purpose was to investigate the effects of kinesio taping (KT) on common biomechanical deficits associated with scapular dyskinesis and shoulder pain. Participants (n = 51) with observable scapular dyskinesis, and without shoulder pain were randomized to KT, KT-placebo, or a no-treatment control group. Measurements taken before, immediately after taping, and 3 days later included pectoralis minor muscle length, lower trapezius muscle strength, scapular upward rotation angle at 0° to 120° in scapular plane humeral elevation and acromiohumeral distance. There were no changes in scapular upward rotation, lower trapezius strength, and acromiohumeral distance immediately after taping or 3 days later compared to baseline (P > .05). The pectoralis minor increased in length in the KT group on day 3 compared to directly after taping (P = .03), but no difference between groups or interaction between time and group were determined (P > .05). Scapular dyskinesis prevalence did not change over time in any group (P > .05). In people with scapular dyskinesis free from shoulder pain, KT applied to the shoulder cannot be recommended to ameliorate the biomechanical deficits associated with shoulder pain.

可观察到的肩胛骨运动障碍与生物力学缺陷有关。旨在纠正这些缺陷的预防性干预措施可能有助于预防肩痛的发展和解决。我们的目的是研究运动贴带(KT)对肩胛骨运动障碍和肩部疼痛相关的常见生物力学缺陷的影响。观察到肩胛骨运动障碍且无肩痛的参与者(n = 51)被随机分为KT组、KT-安慰剂组或无治疗对照组。分别于贴敷前、贴敷后和贴敷3天后测量胸小肌长度、下斜方肌力量、肩胛骨上旋0°至120°肩胛骨平面肱骨抬高角度和肩肱距离。与基线相比,即刻或3天后肩胛骨向上旋转、下斜方肌强度和肩肱距离均无变化(P > 0.05)。与直接贴敷后相比,KT组胸小肌长度在第3天增加(P = 0.03),但组间无差异,时间与组间无交互作用(P > 0.05)。各组肩胛骨运动障碍患病率无明显变化(P > 0.05)。肩胛骨运动障碍无肩痛的患者,不能推荐将KT应用于肩部以改善与肩痛相关的生物力学缺陷。
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引用次数: 0
Development and Assessment of a Method to Estimate the Value of a Maximum Voluntary Isometric Contraction Electromyogram from Submaximal Electromyographic Data. 从亚最大肌电图数据估计最大自主等距收缩肌电图价值的方法的发展和评估。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-01 Epub Date: 2022-02-25 DOI: 10.1123/jab.2021-0229
Hamid Norasi, Jordyn Koenig, Gary A Mirka

The electromyographic (EMG) normalization (often to maximum voluntary isometric contraction [MVIC]) is used to control for interparticipant and day-to-day variations. Repeated MVIC exertions may be inadvisable from participants' safety perspective. This study developed a technique to predict the MVIC EMG from submaximal isometric voluntary contraction EMG. On day 1, 10 participants executed moment exertions of 100%, 60%, 40%, and 20% of the maximum (biceps brachii, rectus femoris, neck flexors, and neck extensors) as the EMG data were collected. On day 2, the participants replicated the joint moment values from day 1 (60%, 40%, and 20%) and also performed MVIC exertions. Using the ratios between the MVIC EMGs and submaximal isometric voluntary contraction EMG data values established on day 1, and the day 2 submaximal isometric voluntary contraction EMG data values, the day 2 MVIC EMGs were predicted. The average absolute percentage error between the predicted and actual MVIC EMG values for day 2 were calculated: biceps brachii, 45%; rectus femoris, 27%; right and left neck flexors, 27% and 33%, respectively; and right and left neck extensors, both 29%. There will be a trade-off between the required accuracy of the MVIC EMG and the risk of injury due to exerting actual MVIC. Thus, using the developed predictive technique may depend on the study circumstances.

肌电图(EMG)归一化(通常达到最大自愿等距收缩[MVIC])用于控制参与者之间和日常变化。从参与者的安全角度考虑,重复使用MVIC可能是不可取的。本研究发展了一种从次极大等长自发性收缩肌电信号预测中心室肌电信号的技术。在第1天,收集肌电数据时,10名参与者进行了100%、60%、40%和20%的最大力矩(肱二头肌、股直肌、颈屈肌和颈伸肌)。在第2天,参与者复制了第1天的关节力矩值(60%,40%和20%),并进行了MVIC练习。利用第1天的MVIC肌电信号与次极大等距自愿收缩肌电信号的比值,以及第2天的次极大等距自愿收缩肌电信号的比值,预测第2天的MVIC肌电信号。计算第2天MVIC EMG预测值与实际值之间的平均绝对百分比误差:肱二头肌,45%;股直肌,27%;左右颈部屈肌,分别占27%和33%;左右颈部伸肌,都是29%。在MVIC肌电图所要求的准确性和由于施加实际MVIC而造成的损伤风险之间存在权衡。因此,使用已开发的预测技术可能取决于研究环境。
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引用次数: 1
Variable Stiffness Shoes for Knee Osteoarthritis: An Evaluation of 3-Dimensional Gait Mechanics and Medial Joint Contact Forces. 膝关节骨关节炎的变刚度鞋:三维步态力学和内侧关节接触力的评估。
IF 1.4 4区 医学 Q2 Medicine Pub Date : 2022-04-01 Epub Date: 2022-03-21 DOI: 10.1123/jab.2021-0217
Ethan Steiner, Katherine A Boyer

The study aim was to quantify the impact of a commercially available variable stiffness shoe (VSS) on 3-dimensional ankle, knee, and hip mechanics and estimated knee contact forces compared with a control shoe. Fourteen participants (10 females) with knee osteoarthritis completed gait analysis after providing informed consent. Shoe conditions tested were control shoe (New Balance MW411v2) and VSS (Abeo SMART3400). An OpenSim musculoskeletal model with static optimization was used to estimate knee contact forces. There were no differences in joint kinematics or in the knee adduction or flexion moments (P = .06; P = .2). There were increases in the knee internal and external rotation (P = .02; P = .03) and hip adduction and internal rotation moments for VSS versus control (P = .03; P = .02). The estimated contact forces were not different between shoes (total P = .3, medial P = .1, and lateral P = .8), but contact force changes were correlated with changes in the knee adduction moment (medial r2 = .61; P < .007). High variability in knee flexion moment changes and increases in the internal rotation moment combined with small decreases in the knee adduction moment did not lead to decreases in estimated contact forces. These results suggest that evaluation of VSS using only the knee adduction moment may not adequately capture its impact on osteoarthritis.

研究的目的是量化市售可变刚度鞋(VSS)对踝关节、膝关节和髋关节三维力学的影响,以及与对照鞋相比估计的膝关节接触力。14名膝关节骨关节炎患者(10名女性)在提供知情同意后完成步态分析。测试的鞋子条件是对照鞋(New Balance MW411v2)和VSS (Abeo SMART3400)。采用静态优化的OpenSim肌肉骨骼模型估计膝关节接触力。关节运动学、膝关节内收、屈曲力矩均无差异(P = 0.06;P = .2)。膝关节内外旋增加(P = 0.02;与对照组相比,VSS组髋关节内收和内旋力矩(P = .03;P = .02)。估计的接触力在鞋子之间没有差异(总P = .3,内侧P = .1,外侧P = .8),但接触力的变化与膝关节内收力矩的变化相关(内侧r2 = .61;P < .007)。膝关节屈曲力矩变化的高度可变性和内旋力矩的增加以及膝关节内收力矩的小幅减少并没有导致估计接触力的减少。这些结果表明,仅使用膝关节内收力矩评估VSS可能无法充分捕捉其对骨关节炎的影响。
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引用次数: 2
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Journal of Applied Biomechanics
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