不同跑步以及快走速度之下對於下肢生物力學以及髖關節壓力分佈的影響

Effect of the different running and fast walking speeds in Lower limb loading and hip pressure distribution

康楷柱(Kai-Chu Kang)

指導教授 ： 林槐庭

高雄醫學大學/醫學院/運動醫學系碩士班/碩士(2016年)

摘要

髖關節是連結下肢與軀幹的關節，承受著上半身的負荷，不管是在走路、跑步還是各種行動中，都扮演著極重要的角色。在日常生活中，慢跑以及快走已經成為許多人運動的主要選擇，也是許多運動員在下肢傷後復建的主要運動，更是許多競技類運動的必要動作。而在跑步及快走的過程中，對於髖關節產生的壓力對一般人、復健中的病患及競技類運動的選手來說是否過大，是醫學上很重要的一個議題。在整個跑步以及快走過程中的單腳觸地期，是由單一下肢來承受身體所有的重量，相對地關節承受的壓力會有一定程度的上昇，且在速度提升之後，推蹬的力量變強，所受到的地面反作用力也隨之提升，相對地也增加關節的受力。而本研究的目的就是利用電腦模擬技術及動作分析系統所收集的資料，探討在不同的跑步以及快走速度之下，髖關節負荷的大小、負荷位置及負荷面積，藉以髖關節在跑步以及快走時所可能遭受的傷害機轉，進而找出較不傷害髖關節且能維持體適能健康的運動方式。在本研究中，利用受測者髖部的Ｘ光片來建立模擬三度空間股骨頭與髖臼可能的接觸面積，再利用高速攝影機和力板收集受測者在不同跑步以及快走速度時運動學及地面反作用力的資料，作為髖關節受到壓力狀況的資料，最後使用電腦模擬數值運算方法-不連續分析計算法，分析髖關節接觸面積及壓力，而這些資料可以作為推論何種動作會對髖關節造成傷害的基礎。本研究的結果發現，在速度越快的情況下，跑步以及快走的下肢關節的關節受力、關節力矩都會隨速度的上升而增加，關節的接觸面積沒有顯著性的改變、髖關節的受力會集中在後側以及內側、峰值壓力會跟著速度上升而上升。而相同速度下的快走以及跑步在關節受力、關節力矩都是跑步較高，髖關節的接觸面積跑步較大、髖關節的峰值壓力也是跑步較高。這發現可以提供給一般人、病患以及運動員作為運動、訓練選擇的參考。而此演算法則可以用來比較不同運動狀態下對於髖關節的壓力。

關鍵字

關節炎 ； 壓力集中 ； 接觸面積

並列摘要

The hip joint is the connection of trunk and lower limb, bearing the load of upper limb. It plays an important role on walking, running and other activities. Running and fast walking are the primary choice for regular exercises, are also the rehabilitation program after injury and the necessary motion in many sports. During running and fast walking, the pressure loading on the hip is an important issue on sports medicine for exercise people, for the patients in rehabilitation, and for athletes. The stance phase of the running and fast walking is bearing the whole body weight by single leg. That is why the hip pressure higher than usual activities. And when speed become faster, the pushing power becomes stronger, the reaction force will be higher and the same of the hip pressure. Therefore, the purpose of this study is using the computer simulation technique and motion analysis system to discuss the hip pressure’s magnitude, location and area when the different speed of running and speed walking. With the result finding the right running and fast walking speed to keep the hip and whole body healthy. In this study, we used the X-ray radiograph to build the three-dimensional possible contact area of femur and acetabular. Using high-speed camera and force plate to collect kinematics data and ground reaction force of the different speed of running and fast walking as the basic data for hip pressure analysis. Finally, using discrete element analysis (DEA) to calculate the contact area and pressure of the hip during running or walking. This data can be the foundation to discuss how the hip be injury. This results showed that the lower limb joint force and torque were higher when the running and walking speed increased. In DEA results, the contact area was not significant different at various speeds, and the hip joint force concentrate on the lateral and medial roof, the peak pressure was higher when speed increased. When walking and running in the same speed, higher lower limb joint force and torque was occurred during running. In DEA result, higher contact area and higher peak pressure also found during running. Our results provide the information about the hip pressure distribution to the people who are applied running or walking as rehabilitation program and training. This algorithm can also apply to calculate the hip joint contact area and peak pressure in different kinds of exercise.

並列關鍵字

arthritis ； pressure concentration ； contact area

參考文獻

Abraham, C. L., Maas, S. A., Weiss, J. A., Ellis, B. J., Peters, C. L., & Anderson, A. E. (2013). A new discrete element analysis method for predicting hip joint contact stresses. J Biomech, 46(6), 1121-1127. doi: 10.1016/j.jbiomech.2013.01.012

Afoke, N. Y., Byers, P. D., & Hutton, W. C. (1987). Contact pressures in the human hip joint. J Bone Joint Surg Br, 69(4), 536-541.

Ageberg, E., Engstrom, G., Gerhardsson de Verdier, M., Rollof, J., Roos, E. M., & Lohmander, L. S. (2012). Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study. BMC Musculoskelet Disord, 13, 73. doi: 10.1186/1471-2474-13-73

Anderson, A. E., Ellis, B. J., Maas, S. A., Peters, C. L., & Weiss, J. A. (2008). Validation of finite element predictions of cartilage contact pressure in the human hip joint. J Biomech Eng, 130(5), 051008. doi: 10.1115/1.2953472

Anderson, T. (1996). Biomechanics and running economy. Sports Med, 22(2), 76-89.