کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6207502 1265662 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Trunk muscle action compensates for reduced quadriceps force during walking after total knee arthroplasty
ترجمه فارسی عنوان
عمل عضلانی تنه در طول پیاده روی بعد از آرتروپلاستی کامل زانو، موجب کاهش نیروی چهارگانه می شود
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
چکیده انگلیسی

Patients with total knee arthroplasty (TKA) frequently exhibit changes in gait biomechanics post-surgery, including decreased ranges of joint motion and changes in joint loading; however, the actions of the lower-limb muscles in generating joint moments and accelerating the center of mass (COM) during walking are yet to be described. The aim of the present study was to evaluate differences in lower-limb joint kinematics, muscle-generated joint moments, and muscle contributions to COM accelerations in TKA patients and healthy age-matched controls when both groups walk at the same speed. Each TKA patient was fitted with a posterior-stabilized total knee replacement and underwent patellar resurfacing. Three-dimensional gait analysis and subject-specific musculoskeletal modeling were used to determine lower-limb and trunk muscle forces and muscle contributions to COM accelerations during the stance phase of gait. The TKA patients exhibited a 'quadriceps avoidance' gait pattern, with the vasti contributing significantly less to the extension moment developed about the knee during early stance (p = 0.036). There was a significant decrease in the contribution of the vasti to the vertical acceleration (support) (p = 0.022) and forward deceleration of the COM (braking) (p = 0.049) during early stance; however, the TKA patients compensated for this deficiency by leaning their trunks forward. This significantly increased the contribution of the contralateral back extensor muscle (erector spinae) to support (p = 0.030), and that of the contralateral back rotators (internal and external obliques) to braking (p = 0.004). These findings provide insight into the biomechanical causes of post-operative gait adaptations such as 'quadriceps avoidance' observed in TKA patients.

► We evaluated leg-muscle function during gait after total knee arthroplasty (TKA). ► TKA patients exhibited a 'quadriceps avoidance' gait pattern. ► Quadriceps had reduced contributions to center-of-mass acceleration in TKA gait. ► TKA patients leaned their trunks forward to compensate for quadriceps avoidance. ► Back muscles had increased contributions to center-of-mass acceleration in TKA gait.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gait & Posture - Volume 38, Issue 1, May 2013, Pages 79-85
نویسندگان
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