后十字韧带的蠕变对大腿屈伸动作协调性影响的研究
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摘要
研究目的:后十字韧带的作用是防止胫骨向后移位,体育运动及日常生活中,后十字韧带所承受的压力是很大的,后十字韧带所承受的强大压力势必会引起自身的蠕变。韧带除了维持所在关节的机械稳定性之外,很多研究证实其中存在着反射弧,蠕变对反射弧会产生什么样的影响?这是一个值得深入探讨的问题。本研究在实验室状态下使受试者后十字韧带发生蠕变,对蠕变量及蠕变前后前后屈肌和伸肌的肌力矩和肌电情况作出分析,得出后十字韧带蠕变后大腿屈伸动作协调性的变化,从而对损伤机理做进一步的探讨。
     研究方法:本研究受试者共24名,其中男性受试者11名,年龄22±2岁,身高179.8±2.7厘米,体重76.2±16.2千克;女生受试者13名,年龄21±1岁,身高164.3±5.0厘米,体重55.9±8.3千克。身体状况良好,膝关节无伤病史。本研究使用的实验仪器主要有CON-TREX肌力评估和训练系统、德国Biovision肌电测试仪、数码摄像机(Sony-DCR-TRV17E)、发光二极管、电子游标卡尺、哑铃、一次性使用EMG电极。实验步骤:1)被试在CON-TREX肌力评估和训练系统上用60°/s做三次膝关节最大力量屈伸活动,休息一分钟后用120°/s做三次膝关节最大力量屈伸活动,仪器记录下肌力矩。用肌电测试仪同步记录下肌电数据,数码摄像机(Sony-DCR-TRV17E)同步拍摄。2)被试坐在椅子上,小腿固定并放在与所坐凳子相同的另一个凳子上,保持腿部与地面平行以及膝关节悬空。在胫骨顶端静力性负荷20kg,保持10min。负重完成后用电子游标卡尺记录下膝关节与地面之间距离的变化量。3)同1)。
     取膝关节三次屈伸活动肌力矩峰值的平均值;对肌电数据进行标准化处理;采用APAS运动分析系统对录像进行处理,得出膝关节角度的屈伸范围;分别选取膝关节在20°、40°、60°和80°下股直肌及股二头肌肌电数据,求出相应的比值。数据的比较采用单因素方差分析(one-way ANOVA),差异显著性水平设定为P=0.05,差异性非常显著水平设定为P=0.01。
     研究结果:1)负重后,男女受试者的蠕变量具有显著性差异(P=0.01)。2)在负重前(屈),负重后(屈),负重前(伸),负重后(伸)时的肌力矩,男性受试者比女性受试者要大,男女受试者差异性非常显著(P<0.01);受试者屈和伸时的肌力矩在负重前后差异性不显著;男性受试者屈和伸时的肌力矩在负重前后差异性不显著;女性受试者在屈时,负重前后肌力矩差异性不显著;低速时时,女性受试者伸的肌力矩负重后非常显著地大于负重前(P=0.003),高速时时,女性受试者伸的肌力矩负重后显著地大于负重前(P=0.003);男性和女性受试者在负重前(屈),负重后(屈),负重前(伸),负重后(伸)时的肌力矩在两种不同的角速度下,差异性不显著。3)低速时,BF/BF在20°,60°,80°负重前后没有显著性差异,在40°负重前后有显著性差异(P=0.035);BF/RF(屈)在20°,80°负重前后没有显著性差异,40°时负重前后有显著性差异(P=0.044*),60°时负重前后有显著性差异(P=0.039);RF/RF,BF/RF(伸)在20°、40°、60°、80°负重前后没有显著性差异。4)高速时,BF/BF,RF/RF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°,负重前后没有显著性差异。5)男性负重前后,低速和高速时BF/BF,RF/RF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°无显著性差异。6)女性负重前后,低速时BF/BF,RF/RF,BF/RF(伸)在20°,40°,60°, 80°无显著性差异;BF/RF(屈)在20°,80°的时候,无显著性差异,40°时有显著性差异(P=0.045),60°时负重前后有显著性差异(P=0.044);高速时BF/BF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°无显著性差异;RF/RF在40°,60°, 80°无显著性差异,在20°时差异性非常显著(P=0.008)。7)男女负重前,低速时BF/BF在40°,60°, 80°无显著性差异,在20°时有显著性差异(P=0.04);RF/RF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°时,无显著性差异;高速时BF/BF,RF/RF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°无显著性差异。8)男女负重后,低速时BF/BF,RF/RF,BF/RF(伸)在20°,40°,60°, 80°无显著性差异;BF/RF(屈)在20°,60°, 80°无显著性差异,在40°时有显著性差异(P=0.039*);高速时BF/BF,RF/RF,BF/RF(屈),BF/RF(伸)在20°,40°,60°, 80°无显著性差异。
     结论:1)女性受试者膝关节后十字韧带的蠕变量比男性受试者大,后十字韧带的强度要小,有更好的膝关节柔韧性。2)与女性相比,男性的肌力矩更大;女性受试者后十字韧带蠕变之后,伸的肌力矩显著大于蠕变前,男性受试者则没有出现差异。3)低速时,被试后十字韧带蠕变之后,屈伸动作的协调性发生了变化,高速时则没有;男性被试后十字韧带蠕变之后,协调性没有发生变化,女性则出现了变化。
     建议:1)女性的后十字韧带强度比男性小,且膝关节柔韧性也较好,所以在日常生活以及体育运动中要注意负荷的强度,避免出现损伤。2)建议在日常生活以及体育运动中,膝关节承受较大负荷之后要有一段时间的休息,以便使十字韧带的蠕变得到恢复。3)体育运动中像压腿这样的热身活动,膝关节要给以适当的支撑,尽量避免后十字韧带的蠕变,以减小受伤的风险。
Research purposes:The role of the posterior cruciate ligament is to prevent the tibiabackward shift, in sports and everyday life, The pressure on the posterior cruciateligament is very strong, and the posterior cruciate ligament will be creep. Ligament inaddition to maintaining the mechanical stability of the joint, many studies haveconfirmed that there is reflex arc, creep on the reflex arc will produce what kind ofimpact? This is a problem worthy of further exploration. In this study, subjects inlaboratory condition , static loading on the knee and make the posterior cruciateligament creep. Analysis flexor and extensor muscle torque and EMG before and aftercreep, co-activation of thigh flexion and extension movements after posterior cruciateligament creep, in order to investigate the damage mechanism.
     Methods: 25 subjects in this study, including 11 male subjects(age 22±2,height179.8±2.7cm, weight 76.2±16.2kg) and 14 female subjects(age 21±1,height164.3±5.0cm,weight 55.9±8.3kg), physical condition is good and knees no injuryhistory. The experimental apparatus used in this study have CON-TREX muscleassessment and training system , Germany Biovision EMG tester, digital camera(Sony-DCR-TRV17E), light-emitting diodes, electronic vernier caliper, dumbbells, aone-time use of EMG electrodes. Experimental steps: 1) subjects in the CON-TREXmuscle assessment and training system with 60°/ s to do the greatest strength of thethree knee flexion and extension activities, rest one minute, with 120°/ s greateststrength to do the three knee flexion and extension activities, the instrumentalrecorded muscle torque. EMG data recorded by EMG tester, Digital video camera(Sony-DCR-TRV17E) synchronization shooting screen. 2) the subjects were sitting ina chair, leg fixed and placed on another same chair, keep the legs parallel to theground and knee vacant. In the top of the tibia static load of 20kg, for 10min.Electronic vernier caliper to record the distance between the knee and the groundchange after loading is completed. 3) like 1).
     Make average of the peak muscle torque what from knee flexion and extension threetimes; EMG data were normalized; APAS motion analysis system were used in videoprocessing, and come to the range of flexion and extension of the knee joint angle;Select the rectus and biceps femoris EMG data as objects when the knee in 20°, 40°,60°and 80°. Data were compared using single factor analysis of variance (one-wayANOVA), the difference significant level was set at P = 0.05, the difference is verysignificant level was set at P = 0.01.
     Results: 1) after loading, the creep of male and female have significant differences(P=0.01). 2)Muscular torque at unloading flexion, loading flexion, unloadingextension, loading extension, male subjects were larger than females and havesignificant differences(P<0.01); In two different angular velocity , the difference isnot significant; at low-speed, extension muscular torque of female subjects beforeloading is larger than after loading(P=0.003), at hign-speed, extension musculartorque of female subjects before loading is larger than after loading(P=0.003).3) atlow-speed, The BF / BF at 20°, 60°, 80°before and after loading have nosignificant differences, at 40°there are significant differences(P=0.035); BF/RF-flexion at 20°, 80°before and after loading have no significant differences, at 40°and60°there are significant differences(P=0.044)(P=0.039); RF / RF, BF/RF- extensionat 20°, 40°, 60°, 80°have no significant differences before and after loading. 4) athigh-speed, BF, / BF, RF / RF, BF/RF- flexion, BF/RF- extension at 20°, 40°, 60°,80°, have no significant differences before and after loading. 5) male subjects beforeand after loading, at low-speed and high-speed ,BF / BF, RF / RF, BF/RF- flexion,BF/RF- extension at 20°, 40°, 60°, 80°have no significant differences. 6) Femalebefore and after loading, at low-speed when the BF / BF, RF / RF, BF/RF- extensionat 20°, 40°, 60°, 80°have no significant differences; BF/RF-flexion at 20°and 80°,have no significant difference before and after loading, at 40°and 60°, havesignificant differences before and after loading(P=0.045)(P=0.044); high-speedwhen the BF / BF, BF/RF-flexion, BF/RF- extension at 20°, 40°, 60°, 80°have nosignificant difference before and after loading; RF / RF at 40°, 60°, 80°have nosignificant differences before and after loading , at 20°have very significant differences before and after loading(P=0.008). 7) Before male and female loading, atlow-speed when the BF / BF at 40°, 60°, 80°have no significant differences beforeand after loading, at 20°have significant differences(P=0.04); RF / RF, BF/RF--flexion, BF/RF- extension at 20°, 40°, 60°, 80°, have no significant differencesbefore and after loading; at high-speed when the BF / BF, RF / RF, BF/RF-flexion,BF/RF- extension at 20°, 40°, 60°, 80°have no significant differences before andafter loading. 8) After male and female loading, at Low-speed when the BF / BF, RF /RF, BF/RF-- extension at 20°, 40°, 60°, 80°have no significant differences beforeand after loading; BF/RF-flexion at 20°, 60°, 80°have no significant differencesbefore and after loading, at 40°have significant differences(P=0.039); at high-speedwhen the BF / BF, RF / RF, BF/RF-flexion, BF/RF- extension at 20°, 40°, 60°, 80°have no significant differences before and after loading.
     Conclusion: 1) The creep of posterior cruciate ligament, female was larger than male.compared with male, intensity of posterior cruciate ligament should be small andhave better knee flexibility. 2) Compared with female, muscle torque of male waslarger than female at low-speed and high-speed. There was no difference in themuscle torque before and after the creep. 3) at low speed, after cruciate ligament creep,flexion and extension movement co-activation was changed but at high speed is not. 4)after cruciate ligament creep of male subjects, co-activation does not change, femalehave changed.
     Suggestion:1)Compared with male, intensity of posterior cruciate ligament offemale should be small and have better knee flexibility. So pay attention to thestrength of the load in daily life and sports, to avoid injury. 2) In daily life and sports,the knees to withstand greater loads to rest for some time, so that the cruciate ligamentcreep have been restored. 3) Sports warm-up activities such as stretching, knee to giveappropriate support to avoid the creep of the posterior cruciate ligament, in order toreduce the risk of injury.
引文
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