躯干运动控制对非接触性膝前交叉韧带损伤机制的影响

Knee valgus and trunk back inclination are the typical characters of non-contact anterior cruciate ligament (ACL). Trunk front inclination may decrease the risk of non-contact ACL injury. However, trunk lateral inclination can increase the risk of non-contact ACL injury. We think that it is necessary to clear the association between trunk and risk factors of ACL injury during cutting maneuvers. The latest study showed the relationship between trunk motion and knee loading at traverses planes during cutting maneuvers. However, only few studies reported what specific postures and control strategies optimally limit frontal and transverse-planes knee loading. We have assured that female basketball athletes have a higher risk of ACL injury during the stop phase of sidestep cutting. For this， we hypothesized that bigger trunk front inclination angle and smaller trunk lateral inclination angle will decrease knee valgus torque and the ratio of hamstring to quadriceps muscle activation during the stop phase of sidestep cutting . Therefore，we plan to approve above-mentioned hypothesization and analysis systemly the relationship between trunk movement and pelvis，hip，knee movement, knee moment and muscle activiy around knee. Clarifing the mechanism of ACL injury and proposing new methods of anterior cruciate ligament injury prevention combination to the results of this study.The result of this item may provide theory foundation for the prevention of ACL injury.

膝外翻和躯干后倾是非接触性膝前交叉韧带损伤时的典型特征。躯干前倾的增加可能会降低非接触性膝前交叉韧带损伤的危险。躯干侧屈的增加则会增加非接触性膝前交叉韧带损伤的危险，我们认为有必要明确方向转换动作中躯干运动和前交叉韧带损伤危险因子之间的关系。最新研究发现侧切动作中躯干运动和膝关节在横切面所承受的负担具有相关性，但关于哪种特定的姿势或控制策略能较好的限制冠状面和横切面膝关节的负担的报道很少。我们在研究中已经证实女性运动员在侧切动作的停止期有较高的前交叉韧带损伤的危险。基于此我们提出侧切动作的停止期，大的躯干前倾角、小的躯干侧屈角将减少膝关节外翻力矩并使大腿后部肌群对大腿四头肌肌电活动量的比值降低的假说。因此，本课题拟证实上述假说，并系统分析躯干运动与骨盆、髋关节、膝关节运动﹑膝关节所受外力以及膝关节周围肌肉肌电活动的关系，阐明膝前交叉韧带损伤的机制，并结合研究的成果提出预防膝前交叉

最新研究发现侧切动作中躯干运动和膝关节在横切面所承受的负担具有相关性，但关于哪种特定的姿势或控制策略能较好的限制冠状面和横切面膝关节的负担的报道很少。我们在研究中已经证实女性运动员在侧切动作的停止期有较高的前交叉韧带(ACL)损伤的危险。本课题围绕着侧切动作的停止期躯干肌活动同骨盆运动、髋关节运动、膝关节运动、膝关节所受外力及膝关节周围肌肉电活动的关联；躯干控制策略和前交叉损伤预防训练方案这些重要问题，从运动学、运动生物力学以及肌电图学三个角度展开系统的研究，完成了研究计划，取得了一系列有特色的创新性成果。结果表明在侧切动作中，躯干运动控制对膝关节ACL有一定影响。当躯干处于前倾控制的运动状态时，可能对ACL有保护性作用从而降低损伤风险。躯干前倾时侧切动作中膝关节的屈曲角度显著增加，峰值伸展力矩显著减小，腘绳肌的肌电活动量显著增加；起跳训练可提高膝关节的功能从而有利于前交叉韧带损伤的预防；穿踝关节平衡装置由站立、下蹲、起跳、跨步及转向组成的ACL损伤预防训练方案不仅可降低ACL损伤的发生率，还可落地及侧切动作发生改变。因此在对运动员的日常训练和竞技指导中，应合理运用躯干控制的作用，从而有效降低ACL的损伤风险，节约医疗费用。