非接触性膝前交叉韧带损伤机理的解明和预防方案的构建

Forefoot landing technique has been reported increasingly affects knee adduction moment loading, which can potentially place a higher strain on the anterior cruciate ligament (ACL). However,few studies have attempted to quantify the knee movement, knee moment and muscle activity around knee related with ankle movement during sidestep cutting. We have proved the mean knee valgus angle peak in players adopted forefoot stopping technique tended to be greater than that in players adopted rearfoot stopping technique during stop phase of sidestep cutting. And we observed the correlationship between knee valgus and ankle varus.According these,we hypothesized that the forefoot stopping technique will produce a significant increase in ankle varus angle, knee valgus angle, knee valgus moment and muscle activity around knee. In order to clarify the mechanism of ACL injury and find new methods of ACL injury prevention combination to the results of this study. We plan to analysis systemly the relationship between ankle movent and knee movement, knee moment and muscle activiy around knee. The result of this item may provide theory foundation for the prevention of ACL.

最新研究发现，前足落地技术增加了侧切动作中膝关节内收力矩,并可能会增加膝前交叉韧带(ACL)的紧张度。但关于侧切动作中踝关节运动与膝关节运动﹑膝关节所受外力及膝关节周围肌肉的肌电活动关系的报道很少。我们在研究中已经证实在侧切动作中采用前足停止技术的运动员，其膝关节外翻角要比采用足跟停止技术的运动员的大，并且发现膝关节外翻和踝关节内翻密切相关。基于此我们提出，采用前足停止技术的运动员在侧切动作的停止期，其踝关节内翻角﹑膝关节外翻角﹑膝关节外翻力矩以及膝关节周围肌肉的肌电活动均较大的假说。因此，本课题拟证实上述假说，并系统分析踝关节运动与膝关节运动﹑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ACL损伤的机制，并结合研究的成果提出预防ACL损伤的新方法。本项目的研究结果将为ACL损伤的预防提供理论依据。

最新研究发现，前足落地技术增加了侧切运动中膝关节内收力矩，并可能会增加膝前交叉韧带的紧张度。但关于侧切运动中踝关节运动和膝关节运动，膝关节所受外力及膝关节周围肌肉的肌电活动关系的报道很少。我们在研究中已经证实在侧切运动中采用前足停止技术的运动员，其膝关节外翻角要比采用足跟停止技术的运动员大，并且发现膝关节外翻和踝关节内翻密切相关。本课题围绕着非接触性膝前交叉韧带损伤机制以及前交叉韧带损伤预防方案这些重要问题，从运动学、运动生物力学以及肌电图学三个方面展开系统的研究，取得了一系列有特色的创新性成果。结果表明侧切运动时足跟落地可增加膝伸展力矩，从而增加前交叉韧带损伤的风险。侧切运动前跑步技术的转换可增加膝关节的外翻角及外翻力矩，为减轻前交叉韧带损伤的风险应避免侧切运动前跑步技术的转换。平衡训练可增加踝关节的稳定性,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、跨步及转向组成的前交叉韧带损伤预防训练方案不仅可降低前交叉韧带损伤的发生率，还可使落地及侧切运动发生改变。这些运动的改变有利于前交叉韧带损伤的预防，从而节约医疗费用。