The Influence of Muscular Tightness of Gastrocnemius on the Ankle Joint Reaction Force during Gait

小腿腓腸肌緊縮於步態期間對踝關節作用力之影響

吳錫昆(Hyi-Kuen Wu) ； 郭芳娟(Fang-Chuan Kuo) ； 蔡永裕(Yung-Yuh Tsai) ； 陳彥文(Yen-Wen Chen) ； 謝悅齡(Yueh-Ling Hsieh) ； 羅鴻基(Hong-Ji Luo) ； 游家源(Jia-Yuan You)

《弘光學報》 52期 (2008/04) Pp. 101-111

https://doi.org/10.6615/HAR.200804.52.10

摘要

目的：肌肉緊縮是一種臨床常見之骨骼肌肉問題，且被認為易導致肌肉受傷的內在危險因素之一。本研究的目是探討小腿腓腸肌緊縮於步態期間對踝關節作用力之影響，以提供臨床人員在處理小腿肌肉緊縮病患的建議。方法：十位具有小腿肌肉緊縮的成年人（5位男性和5位女性）參與本研究，本研究使用標準Helen Hayes的反光球標識器，藉由動作分析系統和兩塊測力板來擷取受測者的步態運動資料。步態期間小腿肌肉緊縮之患側(n=10)及正常健側(n=10)採取統計分析比較其地面反作用力和踝關節作用力。結果：雖然步態運動學(kinematics)顯示患側及正常健側幾乎相似的活動範圍資料，動力學(kinetics)研究顯示肌肉緊縮的下肢相較於正常下肢有明顯增加之踝關節負荷。步態時有明顯增加之尖峰垂直地面反作用力[1.85 0.46倍體重vs. 1.30 0.21倍體重, P= 0.003]，踝關節尖峰關節壓迫作用力[1.79 0.44倍體重vs. 1.25 0.20倍體重, P= 0.001]，發生於腓腸肌緊縮的下肢。結論：步態分析的結果顯示下肢腓腸肌肉緊縮會影響踝關節及足部範圍。足夠的踝關節及足部活動度，對於減少地面傳導到負荷重量下肢之作用力是必要的。定量之步態分析是有價值的，以定義出小腿肌肉緊縮於步態期間對踝關節作用力之影響。

關鍵字

肌肉緊縮 ； 關節作用力 ； 步態分析

並列摘要

Objective. The muscular tightness is a common clinical musculoskeletal problem and is postulated as an intrinsic risk factor for the development of muscle injuries. The purpose of this study was to investigate the influence of the muscular tightness of gastrocnemius on the ankle joint reaction force during gait in order to inform the clinical management of patients with muscular tightness of lower legs. Method. Ten adult subjects (5 males and 5 females) with the muscle tightness of gastrocnemius participated in this study. The motion analysis system and two force plates were applied to capture the gait motions with the standard Helen Hayes marker set. The ground reaction forces and ankle joint reaction forces during the walking trails were compared between the affected (n=10) and unaffected limbs (n=10). Results. Although the kinematic data of gait analysis were quite similar between affected and unaffected limbs, the kinetic findings revealed significantly increased ankle loadings in the affected limbs during gait cycle. The significantly increased peak vertical ground reaction forces [1.85 ± 0.46 times body weight (B.W.) vs 1.30 ± 0.21 B.W., P= 0.003], peak joint compression force in ankle [1.79 ± 0.44 B.W. vs 1.25 ± 0.20 B.W., P= 0.001] were demonstrated in the affected limbs during walking. Conclusion. The results of gait analysis indicated that the muscular tightness of gastrocnemius muscles had an effect on ankle-foot complex. Adequate mobility of ankle-foot joints was necessary for normal attenuation of forces transmitted from the ground to the weight-bearing extremity. The quantitative gait analysis was valuable to clarify the influence of the muscle tightness on the ankle joint reaction forces in the lower extremities.

並列關鍵字

muscular tightness ； joint reaction force ； gait analysis

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