髌股关节痛人群坐站转移中协调模式 及能量流动分析
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北京体育大学

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

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    摘要:

    目的:探索髌股关节痛(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: 本研究招募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(Unilateral Patellofemoral Pain Group,UPFPG)、双侧髌股关节疼痛组(Bilateral Patellofemoral Pain Group,BPFPG)及对照组(Control Group,CG)。使用红外动作捕捉系统(Qualisys,瑞典,采样频率200Hz)和三维测力台(Kistler,瑞士,采样频率1000Hz)进行动作采集,Visual 3D和Matlab计算躯干、骨盆及下肢生物力学指标。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,数据中正值表示环节中能量传入,负值表示传出。不同组别数据采用单因素方差分析进行统计学处理,显著性水平设置为0.05。 结果:额状面协调模式中,FMP阶段骨盆-髋协调模式UPFPG近端协调模式频次多于BPFPG(P=0.024);MTP阶段中躯干-骨盆协调模式UPFPG同相协调模式频次多于BPFPG(P=0.023),CG远端协调模式频次多于UPFPG(P=0.032);膝-踝协调模式中UPFPG、BPFPG远端协调模式频次多于CG (P=0.025、P=0.005)。环节能量流动中,FMP阶段,骨盆MP中BPFPG传出能量高于CG(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;其中,UPFPG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BPFPG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。

    Abstract:

    Objective: To explore limb coordination patterns and energy flow strategies during the Sit-to-Stand (STS) task in individuals with Patellofemoral Pain (PFP), providing theoretical evidence for the pathogenesis of PFP and aiding in the development of treatment and rehabilitation strategies for PFP patients. Methods: This study recruited 36 participants for the STS test, divided into a Unilateral Patellofemoral Pain Group (UPFPG), Bilateral Patellofemoral Pain Group (BPFPG), and a Control Group (CG) based on the number of limbs affected by patellofemoral pain. An infrared motion capture system (Qualisys, Sweden, sampling frequency 200Hz) and a 3D force plate (Kistler, Switzerland, sampling frequency 1000Hz) were used for motion capture. Biomechanical indicators of the trunk, pelvis, and lower limbs were calculated using Visual 3D and Matlab. 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, with positive values indicating energy input and negative values indicating output. Statistical analysis was performed using one-way ANOVA, with a significance level set at 0.05. Results: In the frontal plane coordination pattern, the proximal coordination mode frequency of the pelvis-hip coordination in the FMP phase was higher in UPFPG than in BPFPG (P=0.024). In the MTP phase, the frequency of in-phase coordination in the trunk-pelvis coordination was higher in UPFPG than in BPFPG (P=0.023), while the frequency of distal coordination was higher in CG than in UPFPG (P=0.032). For the knee-ankle coordination pattern, the frequency of distal coordination in CG was lower than that in UPFPG and BPFPG (P=0.025, P=0.005). In segmental energy flow, during the FMP phase, the energy output from the pelvis in MP was higher in BPFPG than in CG (P=0.021). Conclusion: PFP affects energy flow patterns and frontal plane coordination patterns during the STS task. Specifically, individuals in the UPFPG may engage in lateral pelvic and ankle movements as a dynamic compensation for patellofemoral joint pressure, whereas individuals in the BPFPG appear to increase pelvic region energy output and employ a more complex whole-body coordination pattern to compensate for functional deficits in the knee caused by PFP.

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  • 收稿日期:2024-10-16
  • 最后修改日期:2024-10-23
  • 录用日期:2024-10-24
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