陈亚东,白春宏,周怡,等.髌股疼痛综合征患者单腿落地时下肢运动的生物力学特征分析[J].中华物理医学与康复杂志,2026,48(2):141-147
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| 髌股疼痛综合征患者单腿落地时下肢运动的生物力学特征分析 |
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| DOI：10.3760/cma.j.cn421666-20250728-00636 |
| 中文关键词: 髌股疼痛综合征 单腿落地 运动生物力学 动态姿势稳定性 动作捕捉系统 |
| 英文关键词: Patellofemoral pain syndrome Single-leg landing Biomechanics Postural stability Motion capture |
| 基金项目:安徽省质量工程重点研究项目 (2021xsxxkc250)；天津市重点实验室开放基金 (SY-04-20223-004)；武警后勤学院基础研究项目 (WHJ202502) 和 (WHJ202503) |
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| 中文摘要: |
| 目的 系统分析髌股疼痛综合征 (PFPS) 患者在单腿落地动作中的运动生物力学特征，揭示其异常的下肢运动模式及动态姿势控制机制，为制定个体化康复训练方案和预防前交叉韧带损伤提供理论依据。方法 采用病例对照研究，纳入 20 例女性 PFPS 患者（实验组）和 20 名年龄、性别匹配的健康志愿者（对照组）。受试者从 30cm 高跳箱执行单腿落地动作，使用 SimiMotion 动作捕捉系统和 Kistler 三维测力平台采集下肢运动学和动力学参数，获取动态稳定性指数，逐步多元线性回归分析影响动态姿势稳定性的运动学参数。结果 与对照组比较，实验组单腿落地时髋关节屈曲角度减小、内旋受限并表现为外旋、膝关节屈曲内翻角度减少、踝关节外旋受限并表现为内旋（P<0.05），髋关节外展和踝关节跖屈角度增加（P<0.05），地面反作用力峰值降低（P<0.05），前后向和内外侧动态姿势稳定性指数均升高（P<0.05）。线性回归分析显示，对照组中膝关节屈曲角度对前后向稳定性指数有负向影响（P<0.05），膝关节内旋角度对内外侧稳定性指数有正向影响（P<0.05）；实验组中踝关节跖屈角度对内外侧稳定性指数有正向影响（P<0.05）。结论 健康人群单腿落地时主要通过膝关节和髋关节协调运动维持稳定性，PFPS 患者因膝、髋关节屈曲角度不足，采用以踝关节为主导的代偿策略，导致膝关节承受较大冲击力，前后向和内外侧稳定性显著下降。 |
| 英文摘要: |
| Objective To systematically analyze the biomechanics of single-leg landing in cases of patellofemoral pain syndrome (PFPS), so as to identify abnormal lower limb movement patterns and dynamic postural control mechanisms, and provide a theoretical basis for developing individualized rehabilitation programs and preventing anterior cruciate ligament injuries. Methods This case-control study included 20 women with PFPS (the experiment group) and 20 age- and sex-matched healthy controls (the control group). All performed single-leg landings off a 30cm high box. Their lower limb kinematics and kinetics were captured using a SimiMotion motion capture system and a Kistler 3D ground force plate. Dynamic stability indices were calculated, and stepwise multiple linear regression was used to identify kinematic predictors of dynamic postural stability. Results Compared with the control group, the experiment group, on average, showed significantly smaller hip flexion angles and hip internal rotation angles, with a shift toward hip external rotation. Their knee flexion was significantly less, with smaller knee varus angles and ankle external rotation angles with a shift toward internal rotation and greater peak ground reaction force, but a significant increase in hip abduction and ankle plantarflexion angles. On average, the dynamic postural stability indices in the anterior-posterior and medial-lateral directions of the experimental group increased significantly more than among the controls. Among the control group, knee flexion angle was a negative predictor of the anteroposterior stability index, while knee internal rotation angle had a positive relationship with the mediolateral stability index. In the experimental group, ankle plantarflexion angle was a positive predictor of the mediolateral stability index. Conclusions Healthy individuals primarily rely on coordinated movements of the knee and hip joints to maintain stability during single-leg landing. In contrast, those with PFPS tend to exhibit insufficient knee and hip flexion, causing them to adopt an ankle-dominant compensation. Consequently, they experience greater impact forces on the knee during single-leg landing, along with significantly reduced stability in both the anteroposterior (sagittal plane) and mediolateral (frontal plane) directions. |
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