楼梯坡度对健康成人上楼梯行走时膝关节生物力学特征的影响  

Effects of Stair Inclinations on the Biomechanics of Knee Joint of Healthy Adults during Stair Ascent

作　　者：林瑞 李秋捷[1] 杨辰 曲峰[1] 万祥林 Lin Rui;Li Qiujie;Yang Chen;Qu Feng;Wan Xianglin(Beijing Sport University,Beijing 100084,China;Nanjing University of Physical Education,Nanjing 210014,China)

机构地区：[1]北京体育大学,北京100084 [2]南京体育学院,南京210014

出　　处：《中国运动医学杂志》2023年第5期359-365,共7页Chinese Journal of Sports Medicine

基　　金：中央高校基本科研业务费专项资金资助课题(2022QN001)。

摘　　要：目的:探讨楼梯坡度对健康成人上楼梯行走时膝关节负荷等生物力学特征的影响。方法:10名健康成年男性完成高、中、低坡度的上楼梯行走测试,采用Motion红外高速运动捕捉系统和Kistler三维测力台同步采集受试者的体表标志点坐标和地面反作用力数据,建立下肢骨骼肌肉模型,获得支撑相的膝关节三维角度和三维净力矩,计算髌股关节应力最大值和胫股关节内侧接触力第1峰值时刻的膝关节生物力学参数,并采用单因素重复测量方差分析确定不同楼梯坡度对各参数的影响。结果:上中坡度的楼梯时,髌股关节应力最大值以及应力最大值时刻的伸膝力矩大于低坡度(P<0.05);髌股关节应力最大值时刻的髌股关节接触力、股四头肌肌力以及胫股关节内侧接触力第1峰值的伸膝力矩,上高、中坡度楼梯时均大于低坡度(P<0.05);髌股关节应力最大值时刻的屈膝角度与髌股关节接触面积随着楼梯坡度的增加而增大,应力最大值时刻的股四头肌力臂随着楼梯坡度的增加而减小(P<0.05);胫股关节内侧接触力第1峰值及第1峰值的膝内收力矩未受楼梯坡度影响(P>0.05)。结论:与上低坡度楼梯行走相比,上中坡度楼梯会增加髌股关节应力最大值,进而可能会增加髌股关节负荷,从而导致髌股关节损伤风险增加。ObjectiveTo explore the effect of different stair inclinations on the biomechanics of the knee joint of healthy adults during stair ascent.MethodsTen healthy male adults accomplished the stair ascent tasks with a staircase adjusted with different levels of inclinations(high,medium and low levels),the coordinate of the body landmarks and the ground reaction force data were collected using the infrared high speed motion capture system(Motion)and force platforms(Kistler)simultaneously.The musculoskeletal model of lower limbs was then established,which was used to obtain the maximum stress of the patellofemoral joint and the first peak contact force of the tibiofemoral joint during the stance phase,together with the angles and moments of the knee joint.Oneway repeated measures ANOVA was employed to determine the effect of different stair inclinations on diverse parameters.ResultsDuring stair ascent at medium level,the maximum patellofemoral joint stress and the knee extension moment at this point was greater than the low level(P0.05).Moreover,the patellofemoral joint force and quadriceps strength at the time of the maximum patellofemoral joint stress for the high and medium level inclination was greater than the low level,and the knee extension moment at the first peak of the medial tibiofemoral joint contact force for the formen was also greater than the latter(P0.05).The knee flexion angle and patellofemoral joint contact area at the time of the maximum patellofemoral joint stress increased with the stair inclination,and the quadriceps muscle moment decreased with the stair inclination(P0.05).The first peak of the medial tibiofemoral joint contact force,and the knee adduction moment at the first peak contact force were not affected by the stair inclinations(P0.05).ConclusionCompared with stairs of low inclination,ascending stairs of medium inclination showed greater maximum patellofemoral joint stress,which may increase the patellofemoral joint loads and risks of patellofemoral joint injury.

关 键 词：楼梯坡度 上楼梯 膝骨关节炎 步态分析 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] G804.6[医药卫生—基础医学] R684[文化科学—运动人体科学]