髌股关节痛人群坐站转移中协调模式及能量流动分析  

Analysis of Coordination Patterns and Energy Flow in Patellofemoral Pain Syndrome During Sit-to-Stand Transitions

作　　者：李磊 柳璇 李晨 倪新迪 黄龙 刘晔 LI Lei;LIU Xuan;LI Chen;NI Xindi;HUANG Long;LIU Ye(School of Sport Science,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学运动人体科学学院,北京100084

出　　处：《医用生物力学》2025年第1期171-178,共8页Journal of Medical Biomechanics

基　　金：中央高校基本科研业务费专项资金(2024015)。

摘　　要：目的 探索髌股关节痛(patellofemoral pain, PFP)人群坐站运动(sit-to-stand, STS)过程中肢体协调模式及能量流动策略,为PFP患者的发病机制及后续制定治疗康复方式提供理论依据。方法 招募36名受试者进行STS测试,依据髌股关节疼痛肢体数目将受试者分为单侧髌股关节疼痛组(单侧组)、双侧髌股关节疼痛组(双侧组)及对照组。使用红外动作捕捉系统和三维测力台进行动作采集。采用Visual 3D和Matlab软件,分别计算躯干与骨盆的角度、角速度、线速度及近端和远端关节力。同时,计算下肢髋、膝、踝关节的角度、力矩、关节力及大腿和小腿的角速度与线速度数据。采用矢量编码计算耦合角表示协调模式,环节净能量积分计算各阶段环节中的能量流。结果 额状面协调模式中,屈曲动量阶段骨盆-髋协调模式单侧组近端协调模式频次多于双侧组(P=0.024);动量传递阶段躯干-骨盆协调模式单侧组同相协调模式频次多于双侧组(P=0.023),而远端协调模式频次单侧组少于对照组(P=0.032);膝-踝协调模式中单侧组、双侧组远端协调模式频次多于对照组(P=0.025,P=0.005)。环节能量流动中,屈曲动量阶段骨盆肌肉功率中双侧组传出能量高于对照组(P=0.021)。结论 PFP人群影响STS过程中能量流动模式及额状面的运动协调模式。单侧髌股关节疼痛人群可能通过骨盆和踝关节的侧向运动进行动态代偿髌股关节压力,而双侧髌股关节疼痛人群则为增加骨盆区域能量输出和更复杂的全身协调模式以弥补PFP所导致的膝关节功能不足。Objective To explore limb coordination patterns and energy flow strategies during the sit-to-stand(STS)transition in individuals with patellofemoral pain(PFP),so as to provide a theoretical evidence for the pathogenesis of PFP and subsequent formulation of treatment and rehabilitation strategies for PFP patients.Methods A totoal of 36 participants was recruited for the STS test.They were divided into the unilateral PFP group(unilateral group),bilateral PFP group(bilateral group),and control group,based on the number of limbs affected by PFP.An infrared motion capture system and a three-dimensioanl force plate were used for motion capture.Visual 3D and Matlab software were used to calculate the trunk and pelvis angles,angular velocities,linear velocities,and proximal and distal joint forces.Additionally,the angles,torques,and joint forces of the hip,knee,and ankle joints,along with the angular and linear velocities of the thigh and shank,were computed.Coupling angles was used to represent coordination patterns via vector coding;the segmental net energy integration method was used to calculate energy flow within segments at each stage.Results For the coordination pattern at frontal plane,the proximal coordination mode frequency of the pelvis-hip coordination in the flexion momentum phase(FMP)was higher in unilateral group than that in bilateral group(P=0.024).In the momentum transfer phase(MTP),the frequency of in-phase coordination in the trunk-pelvis coordination was higher in unilateral group than that in bilateral group(P=0.023),while the frequency of distal coordination was higher in control group than in that in unilateral group(P=0.032).For the knee-ankle coordination pattern,the frequency of distal coordination in control group was lower than that in unilateral and bilateral groups(P=0.025,P=0.005).In segmental energy flow,during the FMP,the energy output from the pelvis during extension phase(MP)was higher in bilateral group than that in control group(P=0.021).Conclusions PFP affects energy flow patterns a

关 键 词：髌股关节痛 坐站运动 协调模式 能量流动 

分 类 号：R318.01[医药卫生—生物医学工程]