膝关节前交叉韧带断裂者跑步时的步态分析特征及指导意义  

Gait analysis characteristics and their guiding significance for knee cruciate ligament rupture during running

作　　者：任爽[1] 印钰[1] 张思 梁子轩 于媛媛[1] 时会娟 苗欣[1] 李玳[1] 胡晓青[1] 黄红拾[1] 敖英芳[1] REN Shuang;YIN Yu;ZHANG Si;LIANG Zixuan;YU Yuanyuan;SHI Huijuan;MIAO Xin;LI Dai;HU Xiaoqing;HUANG Hongshi;AO Yingfang(Department of Sports Medicine,Peking University Third Hospital.Institute of Sports Medicine of Peking University.Beijing Key Laboratory of Sports Injuries,Beijing 100191,China)

机构地区：[1]北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京100191

出　　处：《科技导报》2021年第22期43-48,共6页Science & Technology Review

基　　金：国家自然科学基金项目(31900943,31900961);北京大学医学部教育教学研究项目(2020YB44);北京大学医学部青年培育基金项目(BMU2021PY001);北京市自然科学基金项目(7202232)

摘　　要：为明确前交叉韧带(anterior crucitate ligament,ACL)断裂后患者的跑步步态以及合并内侧半月板后角撕裂对其进一步的影响,基于三维运动捕捉分析方法,定量化分析了前交叉韧带断裂患者(8名单纯ACL断裂患者,8名ACL断裂合并内侧半月板后角撕裂患者,22名健康志愿者)的跑步步态改变。研究表明,慢跑时ACL断裂的膝关节主要表现为外源性屈曲力矩显著降低,这不仅与ACL断裂侧伸肌力量减弱有关,且与神经肌肉控制模式改变有关。ACL断裂合并内侧半月板撕裂患者膝关节在慢跑时表现出显著的外旋不稳,分析与内侧半月板后角撕裂降低了对旋转稳定性的控制功能有关。研究提示,ACL断裂患者的康复训练方案应关注并参考其跑步步态的异常,加强屈伸肌及旋转稳定肌群的训练,结合神经肌肉训练,改善其跑步步态异常,降低继发损伤风险。This paper identifies the changes of the running gait after the ACL rupture and the further effects of the concomitant medial meniscus tear on the running gait changes after the ACL rupture.Based on the 3D motion capture analysis method,quantitative analyses are made for the changes of the running gait in the ACL-deficient patients(22 healthy controls,8 isolated ACL-deficient patients,8 ACL-deficient concomitant with medial meniscus tear patients).The results show that for the ACL-deficient knee joint,a significant decrease of the exogenous flexion moment is observed during jogging,which is not only related to the weakening of the extensor muscle strength of the ACL-deficient side,but also related to the change of the neuromuscular control mode.For the patients with ACL rupture combined with the medial meniscus tear,a significant external rotation instability of the knee is observed during jogging,which may be related to the reduced control of rotation stability caused by the medial meniscus posterior horn tear.It is suggested that in the rehabilitation training program for the ACL rupture patients,one should pay attention to their abnormal running gait and intensify the training of flexor and extensor muscles and rotational muscle group and the neuromuscular training to improve their abnormal running gait and reduce the risk of the secondary injury after the ACL rupture.

关 键 词：前交叉韧带断裂 步态分析 生物力学 

分 类 号：R686.5[医药卫生—骨科学]