不同类型女性髌股关节疼痛综合征患者的下肢生物力学特征  

Biomechanical characteristics of lower limbs in female patients with different types of patellofemoral pain syndrome

作　　者：董友清 魏子轩 吴海鸥 陈瑞兄 段鹏 陈楠 林熙凯 Dong Youqing;Wei Zixuan;Wu Haiou;Chen Ruixiong;Duan Peng;Chen Nan;Lin Xikai(Department of Rehabilitation Medicine,Shishou People's Hospital,Shishou 434400,Hubei Province,China;College of Sports Medicine,Wuhan Sports University,Wuhan 430079,Hubei Province,China;Hubei Province Sports Science Institute,Wuhan 430205,Hubei Province,China;Department of Tuina,Beijing University of Chinese Medicine Shenzhen Hospital(Longgang),Shenzhen 518172,Guangdong Province,China)

机构地区：[1]湖北省石首市人民医院康复医学科,湖北省石首市434400 [2]武汉体育学院运动医学院,湖北省武汉市430079 [3]湖北省体育科学研究所,湖北省武汉市430205 [4]北京中医药大学深圳医院(龙岗)推拿科,广东省深圳市518172

出　　处：《中国组织工程研究》2025年第21期4458-4468,共11页Chinese Journal of Tissue Engineering Research

基　　金：湖北省教育厅科学研究计划项目(B2021193),项目参与人:林熙凯。

摘　　要：背景:目前国内外关于髌股关节疼痛综合征的运动学和动力学研究已经涉及到上下楼梯、行走等日常生活活动。但是不同距下关节状态的髌股关节疼痛综合征年轻女性患者的下肢生物力学特征尚未见报道。目的:探究不同距下关节功能状态的髌股关节疼痛综合征年轻女性患者的下肢生物力学特征,为临床治疗不同类型的髌股关节疼痛综合征提供理论支撑。方法:共纳入受试者33例,其中健康对照组(C组)10例,其余27例髌股关节疼痛综合征受试者根据足姿指数分组,距下关节正常组(A组,足姿指数0-6分)14例,距下关节异常组(B组,足姿指数7-12分)13例。采集各组受试者在正常速度下阶梯时的生物力学指标并进行对比,运动学指标选取初始触地时刻与支撑期屈膝角度最大时刻的髋膝三维关节角度与踝矢状面关节角度;动力学指标选取支撑期屈膝角度最大时刻的髋膝三维关节力矩与踝矢状面关节力矩;表面肌电指标选取股内侧肌、股外侧肌、股直肌、半腱半膜肌、股二头肌和臀中肌在预激活阶段和缓冲阶段的均方根振幅。结果与结论:(1)在初始触地时刻,A组相较于B组有更大的屈膝角度(P <0.05)、髋外旋角度(P <0.01)和更小的膝外旋角度(P <0.01);A组与C组相比有更大的屈膝角度和更小的屈髋角度(均为P<0.01);B组和C组相比有更大的膝外旋角度和更小的髋外旋角度、屈髋角度(均为P<0.01);(2)在屈膝角度最大时刻,A组相较于B组有更小的膝外翻角度(P<0.05)、膝外旋角度(P<0.05)和更大的屈膝角度(P<0.01);A组相较于C组有更小的膝外翻角度(P <0.05)、屈髋角度(P <0.01)和髋外旋角度(P <0.05);B组相较于C组有更小的屈膝角度、屈髋角度、髋外旋角度和更大的膝外旋角度(均为P <0.01);且A组相较于C组有更大的髋内旋力矩(P <0.05)和跖屈力矩(P <0.01);(3)在正常速度下阶梯缓冲阶段时,C组相较于A组有更大的�BACKGROUND:Currently,research both domestically and internationally on patellofemoral pain syndrome has explored the kinematics and dynamics during daily activities such as stair ascent and descent,and walking.However,there is a lack of studies examining the lower limb biomechanical characteristics of young female patients with patellofemoral pain syndrome in different squatting conditions.OBJECTIVE:To investigate the lower limb biomechanical characteristics among young female patients with patellofemoral pain syndrome in different functional states of the subtalar joint,providing theoretical support for the clinical treatment of various types of patellofemoral pain syndrome.METHODS:A total of 33 participants were included in this study.There were 10 subjects in the healthy control group(group C).The other 27 subjects with patellofemoral pain syndrome were divided into two groups according to the foot posture index:14 subjects in the normal subtalar joint group(group A,foot posture index 0-6 points)and 13 subjects in the abnormal subtalar joint group(group B,foot posture index 7-12 points).The biomechanical indices of the subjects in each group were collected and compared when they walked on stairs at normal speed.The kinematic indices included the three-dimensional joint angles of the hip and knee and the sagittal plane joint angles of the ankle at the initial contact moment and the moment of maximum knee flexion angle during the stance period.The dynamic indices included the three-dimensional joint torques of the hip and knee and the sagittal plane joint torques of the ankle at the moment of maximum knee flexion angle during the stance period.The surface electromyography indices included the root mean square amplitudes of the vastus medialis,vastus lateralis,rectus femoris,semitendinosus and semimembranosus,biceps femoris,and gluteus medius in the pre-activation stage and the buffering stage.RESULTS AND CONCLUSION:(1)At the initial ground contact moment,group A exhibited a greater knee flexion angle(P<0.05),gre

关 键 词：距下关节 髌股关节疼痛综合征 运动学 动力学 表面肌电 日常生活活动 女性 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R873