正走和倒走的膝关节生物力学特征比较

目的 比较正走和倒走两种不同行走模式时膝关节的生物力学特征。方法 采用三维运动捕捉系统Vicon T40和测力台AMTI OR6-7采集并比较13名健康青年男性志愿者正走和倒走时的时间、空间、运动学和动力学参数。结果 与正走相比，倒走时的步速、步频和步幅均显著减小，跨步周期和支撑相所占百分比显著增加；在矢状面上，倒走时膝关节活动度、最大屈伸力矩较正走小；在冠状面上，倒走时膝关节内翻外展活动范围也较正走小，内翻力矩峰值在支撑早期较正走小，但在支撑晚期较正走大；地面反作用力在支撑早期较正走大，但在支撑晚期较正走小。结论 倒走和正走膝关节生物力学特征差异明显。与正走相比倒走在支撑相早期能减轻膝关节内侧间室的负荷，而倒走在支撑相晚期对膝关节负荷的影响则尚须进一步研究。
Objective To compare biomechanical characteristics of the knee joint during forward walking and backward walking. Methods Temporal-spatial, kinematics, kinetics parameters of 13 healthy young male volunteers were collected and compared by 3D motion capture system Vicon T40 and force platforms AMTI OR6-7. Results Compared with forward walking, the speed, cadence and stride length significantly decreased, while the gait cycle and stance phase percentage in gait cycle significantly increased during backward walking. In the sagittal plane, the range of motion (ROM), the maximum flexion/extension moment of the knee were smaller during backward walking. In the frontal plane, the ROM of knee varus/valgus during backward walking decreased, and the peak value of knee adduction moment significantly reduced in the early stance phase while significantly increased in the late stance phase of backward walking. The peak value of ground reaction force (GRF) was significantly larger in the early stance phase while smaller in the late stance phase during backward walking than that during forward walking. Conclusions The biomechanical characteristics of the knee joint during forward walking and backward walking are significantly different. Compared with forward walking, backward walking is helpful to reduce the medial compartment load in the early stance phase. Further study will be needed to investigate the effects of backward walking on knee joint loading in the late stance phase.