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Somatosensory Function Influences Aberrant Gait Biomechanics Following Anterior Cruciate Ligament Reconstruction.

体感功能影响前交叉韧带重建后异常步态生物力学。

  • 影响因子:3.07
  • DOI:10.1002/jor.24495
  • 作者列表:"Blackburn JT","Pietrosimone B","Spang JT","Goodwin JS","Johnston CD
  • 发表时间:2020-03-01
Abstract

:Osteoarthritis is common following anterior cruciate ligament reconstruction (ALCR), and aberrant gait biomechanics are considered a primary contributor. Somatosensory dysfunction potentially alters gait biomechanics, but this association is unclear. Therefore, the purposes of this investigation were to compare somatosensory function between limbs and evaluate associations between somatosensory function and gait biomechanics linked to osteoarthritis development in individuals with ALCR. Seventy-three volunteers with ALCR participated. Gait biomechanics (peak vertical ground reaction force magnitude and loading rate, peak internal knee extension and valgus moments, peak knee flexion and varus angles, and quadriceps/hamstrings co-activation) were assessed as subjects walked at their preferred speed. The somatosensory function was assessed via joint position sense error (knee flexion) and vibratory perception threshold (femoral epicondyles, malleoli, and first metatarsal). Though somatosensory function did not differ between the ACLR and contralateral limbs, poorer joint position sense in the ACLR limb was associated with lower loading rates and internal knee extension moments, and greater co-activation. Poorer vibratory perception at the medial and lateral malleoli and first metatarsal head in the ACLR limb was associated with lower loading rates, greater internal knee valgus moments and varus angles, and greater co-activation. Poorer vibratory perception at the medial malleolus and first metatarsal head in the contralateral limb was associated with greater peak knee varus angles and internal knee valgus moments. These results suggest that future research evaluating rehabilitation approaches for improving somatosensory function is warranted as a potential approach for restoring normal gait biomechanics and reducing osteoarthritis risk. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:620-628, 2020.

摘要

: 骨关节炎在前交叉韧带重建 (ALCR) 后很常见,异常步态生物力学被认为是主要因素。躯体感觉功能障碍可能改变步态生物力学,但这种相关性尚不清楚。因此,本研究的目的是比较肢体间的躯体感觉功能,评价躯体感觉功能和步态生物力学与ALCR个体骨关节炎发展的相关性。73 名ALCR志愿者参加。步态生物力学 (峰值垂直地面反作用力大小和负重率,峰值内伸和外翻力矩,峰值膝关节屈曲和内翻角度,股四头肌/腘绳肌共激活) 被评估为受试者以他们的首选速度行走。通过关节位置觉误差 (膝关节屈曲) 和振动觉阈值 (股骨上髁、踝和第一跖骨) 评估躯体感觉功能。虽然体感功能在ACLR和对侧肢体之间没有差异,但ACLR肢体的关节位置感觉较差与较低的负荷率和膝关节内伸展力矩以及较大的共激活相关。ACLR肢体内外踝和第一跖骨头的振动感知较差,与较低的负荷率、较大的膝内翻力矩和内翻角度以及较大的共激活相关。对侧肢体内踝和第一跖骨头振动感知较差,与较大的膝关节内翻角度和膝内翻力矩相关。这些结果表明,未来评估改善躯体感觉功能的康复方法的研究值得作为恢复正常步态生物力学和降低骨关节炎风险的潜在方法。©2019 骨科研究学会。由Wiley journals,Inc.发表J Orthop Res 38:620-628,2020。

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