تاثیر زانوی پرانتزی بر فعالیت پیش بینانه، الگوی زمان بندی عضلات و زمان رسیدن به پایداری حین پرش – فرود تک پا

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناس ارشد گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه علامه طباطبائی تهران، تهران، ایران

2 استادیار گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه علامه طباطبائی تهران، تهران، ایران

3 دانشیار گروه آسیب شناسی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه شهید بهشتی تهران، تهران، ایران

چکیده

هدف:
زانوی پرانتزی از شایع ترین ناهنجاری های اندام تحتانی است که با اختلال در عملکرد افراد همراه است، اما راستای اندام و همچنین فعالیت عضلات در حین فعالیت های ورزشی در این افراد کمتر مورد توجه قرار گرفته است. هدف این مطالعه، بررسی تأثیر زانوی پرانتزی بر فعالیت پیش بینانه، زمان بندی عضلات و زمان رسیدن به پایداری حین پرش- فرود می باشد.
روش بررسی:
در این تحقیق مقطعی،30 نفر ورزشکار (15 نفر با زانوی پرانتزی و 15 نفر بدون آن) شرکت کردند. زانوی پرانتزی با استفاده از کولیس با دقت 01/0 میلیمتر اندازه گیری شد. زمان رسیدن به پایداری با استفاده از صفحه نیرو در حرکت پرش- فرود ارزیابی شد. با استفاده از اطلاعات ثبت شده توسط دستگاه الکترومیوگرافی که با صفحه نیرو همزمان شده بود میزان و زمان آغاز فعالیت عضلات محاسبه و برای تجزیه و تحلیل در برنامه متلب استخراج شد. برای تجزیه و تحلیل آماری داده ها از آزمون t مستقل با سطح معناداری (p≤0/05) استفاده گردید.
یافته ها:
نتایج  نشان داد که میزان فعالیت عضله سرینی میانی(0/003=p) در افراد زانوی پرانتزی کمتر از افراد طبیعی است و این تفاوت از لحاظ آماری معنی دار شد. اما مقایسه فعالیت سرینی بزرگ، دوسر رانی و نیم وتری بین دو گروه معنی دار نشد. همچنین مقایسه زمان آغاز فعالیت عضلات بین دو گروه معنی دار نشد(0/05<p). همچنین مقایسه زمان رسیدن به پایداری در راستای داخلی – خارجی (0/003=p) و کلی (0/01=p) در افراد زانوی پرانتزی بیشتر از افراد طبیعی است و این تفاوت معنی دار شد. اما در راستای قدامی - خلفی بین دو گروه معنی دار نشد (0/05<p).
 
نتیجه گیری:
به نظر می ­­رسد واروس زانو  Knee Varus عاملی اثر گذار بر بیومکانیک پرش- فرود­ باشد به طوری که باعث کاهش فعالیت عضله سرینی میانی می­شود. این تغییرات ممکن است با کاهش ثبات طرفی و افزایش احتمال آسیب دیدگی در ورزشکاران همراه باشد.

کلیدواژه‌ها


  1. Lewek MD, Rudolph KS, Snyder-Mackler L. Control of frontal plane knee laxity during gait in patients with medial compartment knee osteoarthritis. Osteoarthritis and Cartilage 2004; 12(9): 745-751.
  2. Van Gheluwe B, Kirby KA, Hagman F. Effects of simulated genu valgum and genu varum on ground reaction forces and subtalar joint function during gait. Journal of the American Podiatric Medical Association 2005; 95(6): 531-541.
  3. Twomey D, McIntosh A, Simon J, Lowe K, Wolf S. Kinematic differences between normal and low arched feet in children using the Heidelberg foot measurement method. Gait & posture 2010; 32(1): 1-5.
  4. Carter R, Tarteval F, Marks R. Knee muscle torques of healthy adults with tibia vara: Hypothetical relationship to medial compartment knee osteoarthrosis. Isokinetics and exercise science 2002; 10(3): 159-165.
  5. Ramsey DK, Snyder‐Mackler L, Lewek M, Newcomb W, Rudolph KS. Effect of anatomic realignment on muscle function during gait in patients with medial compartment knee osteoarthritis. Arthritis Care & Research 2007; 57(3): 389-397.
  6. Marks R, Kumar S, Semple J, Percy JS. Quadriceps femoris activation in healthy women with genu varum and women with osteoarthrosis and genu varum. Journal of Electromyography and Kinesiology 1994; 4(3): 153-160.
  7. Silvers HJ, Mandelbaum BR. ACL injury prevention in the athlete. Sport-Orthopädie-Sport-Traumatologie-Sports Orthopaedics and Traumatology 2011; 27(1): 18-26.
  8. Borghuis J, Hof AL, Lemmink KA. The importance of sensory-motor control in providing core stability. Sports medicine 2008; 38(11): 893-916.
  9. Santello M, McDonagh MJ, Challis JH. Visual and non‐visual control of landing movements in humans. The Journal of Physiology. 2001;537(1):313-327. 
  10. Baratta R, Solomonow M, Zhou B, Letson D,et at . Muscular coactivation: the role of the antagonist musculature in maintaining knee stability. The American journal of sports medicine 1988; 16(2): 113-122.
  11. Hewett T, Zazulak B, Myer G, Ford K. A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes. British journal of sports medicine 2005; 39(6): 347-350.'
  12. Puckree T, Govender A, Govender K, Naidoo P. The quadriceps angle and the incidence of knee injury in Indian long-distance runners. South African Journal of Sports Medicine 2007; 19(1): 9-11.
  13. Devita P, Skelly WA. Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Med Sci Sports Exerc 1992; 24(1): 108-115.
  14. Wu H-W, Liang K-H, Lin Y-H, Chen Y-H, Hsu H-C, editors. Biomechanics of ankle joint during landing in counter movement jump and straddle jump. Bioengineering Conference, 2009 IEEE 35th Annual Northeast; 2009: 189-200.
  15. Ali N RG, Robertson G. Gender. Vertical Height and Horizontal Distance Effects on Single-Leg Landing Kinematics: Implications for Risk of non-contact ACL Injury. J Hum Kinet 2013; 37: 27-38.
  16. Bruton MR ODN, Adams R. Sex differences in the kinematics and neuromuscular control of landing: biological, environmental and sociocultural factors. J Electromyography kinesiology 2013; 23(4): 747-758.
  17. Hollman JH HJ, Kraft JL, Strauss JD, Traver KJ. Effects of hip extensor fatigue on lower extremity kinematics during a jump-landing task in women: a controlled laboratory study. Clinical Biomechanics 2012; 27(9): 903-909.
  18. Homan KJ NM, Goerger BM, Prentice WE, Blackburn JT. The influence of hip strength on gluteal activity and lower extremity kinematics. J Electromyography kinesiology 2013; 23(2):4 11-415.
  19. Sheikhhoseini R, O'Sullivan K, Alizadeh MH, Sadeghisani M. Altered motor control in athletes with low back pain: a literature review. Annals of Applied Sport Science 2016; 4(4): 43-50.
  20. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. Journal of athletic training 2002; 37(1): 71-92.
  21. Sheikhhoseini R, Alizadeh M-H, Salavati M, O'Sullivan K, et al. Altered Lower Limb Kinematics during Jumping among Athletes with Persistent Low Back Pain. Annals of Applied Sport Science. 2018:10-21
  22. Earl JE, Hertel J, Denegar CR. Patterns of dynamic malalignment, muscle activation, joint motion, and patellofemoral-pain syndrome. Journal of sport rehabilitation 2005; 14(3): 216-233.
  23. Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. journal of orthopaedic & sports physical therapy 2010; 40(2): 42-51.      
  24. Hollman JH, Ginos BE, Kozuchowski J, Vaughn AS, et al. Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down. Journal of sport rehabilitation 2009; 18(1): 104-117
  25. Lee TQ, Morris G, Csintalan RP. The influence of tibial and femoral rotation on patellofemoral contact area and pressure. Journal of Orthopaedic & Sports Physical Therapy 2003; 33(11): 686-693.
  26. Emery C, Tyreman H. Sport participation, sport injury, risk factors and sport safety practices in Calgary and area junior high schools. Paediatrics & child health 2009; 14(7): 439-444.
  27. Chaudhari AM, Andriacchi TP. The mechanical consequences of dynamic frontal plane limb alignment for non-contact ACL injury. Journal of biomechanics 2006; 39(2): 330-338.
  28. Murphy D, Connolly D, Beynnon B. Risk factors for lower extremity injury: a review of the literature. British journal of sports medicine 2003; 37(1): 13-29.
  29. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods 2007; 39(2): 175-191.
  30. Badii M, Wade AN, Collins DR, Nicolaou S, et al. Comparison of lifts versus tape measure in determining leg length discrepancy. The Journal of rheumatology 2014; 41(8): 1689-1694.
  31. McRoberts LB, Cloud RM, Black CM. Evaluation of the New York Posture Rating Chart for assessing changes in postural alignment in a garment study. Clothing and Textiles Research Journal. 2013;31(2):81-96.
  32. Samaei A, Bakhtiary A, Elham F, Rezasoltani A. Effects of genu varum deformity on postural stability. International journal of sports medicine 2012; 33(06): 469-473.
  33. Fortin C, Ehrmann Feldman D, Cheriet F, Labelle H. Clinical methods for quantifying body segment posture: a literature review. Disability and rehabilitation 2011; 33(5): 367-383.
  34. Carcia CR, Martin RL. The influence of gender on gluteus medius activity during a drop jump. Physical Therapy in Sport 2007; 8(4): 169-176.
  35. De Luca CJ, Gilmore LD, Kuznetsov M, Roy SH. Filtering the surface EMG signal: Movement artifact and baseline noise contamination. Journal of biomechanics 2010; 43(8): 1573-1579.
  36. Stegeman D, Hermens H. Standards for surface electromyography: The European project Surface EMG for non-invasive assessment of muscles (SENIAM). Enschede: Roessingh Research and Development 2007: 12-108.
  37. Webber M. Cytopathic effects in primary epithelial cultures derived from the human prostate. Investigative urology. 1976;13(4):259-270
  38. Lieberman DE, Raichlen DA, Pontzer H, Bramble DM, Cutright-Smith E. The human gluteus maximus and its role in running. Journal of Experimental Biology 2006; 209(11): 2143-2155.
  39. Hadadnezhad M, Rajabi R, Jamshidi AA, Shirzad E. The Effect of Plyometric Training on Trunk Muscle Pre-activation in Active Females with Trunk Neuromuscular Control Deficit. Journal of Shahid Sadoughi University of Medical Sciences 2014; 21(6): 705-715.
  40. Botter A, Oprandi G, Lanfranco F, Allasia S, et al. Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning. European journal of applied physiology 2011; 111(10): 24-61.
  41. Gribble PA, Mitterholzer J, Myers AN. Normalizing considerations for time to stabilization assessment. Journal of science and medicine in sport 2012; 15(2): 159-163.
  42. Ross SE, Guskiewicz KM, Yu B. Single-leg jump-landing stabilization times in subjects with functionally unstable ankles. Journal of athletic training 2005; 40(4): 298-311.
  43. Ross SE, Guskiewicz KM, Gross MT, Yu B. Assessment tools for identifying functional limitations associated with functional ankle instability. Journal of athletic training 2008; 43(1): 44-50.
  44. Goldberg EJ, Neptune RR. Compensatory strategies during normal walking in response to muscle weakness and increased hip joint stiffness. Gait & posture 2007; 25(3): 360-367.
  45. Rutherford DJ, Hubley-Kozey CL, Stanish WD. The neuromuscular demands of altering foot progression angle during gait in asymptomatic individuals and those with knee osteoarthritis. Osteoarthritis and cartilage 2010; 18(5): 654-661.
  46. Iida Y, Kanehisa H, Inaba Y, Nakazawa K. Activity modulations of trunk and lower limb muscles during impact-absorbing landing. Journal of Electromyography and Kinesiology 2011; 21(4): 602-609.
  47. Santello M. Review of motor control mechanisms underlying impact absorption from falls. Gait & posture 2005; 21(1): 85-94. 
  48. McNair PJ, Prapavessis H, Callender K. Decreasing landing forces: effect of instruction. British Journal of Sports Medicine 2000; 34(4): 293-296.
  49. Fu S, Hui-Chan C. Mental set can modulate response onset in the lower limb muscles to falls in humans. Neuroscience letters 2002; 321(1-2): 77-80.
  50. Ali N, Robertson DGE, Rouhi G. Sagittal plane body kinematics and kinetics during single-leg landing from increasing vertical heights and horizontal distances: Implications for risk of non-contact ACL injury. The Knee 2014; 21(1): 38-46.
  51. Yeow CH, Lee PV, Goh JC. Sagittal knee joint kinematics and energetics in response to different landing heights and techniques. The Knee 2010; 17(2): 127-131.
  52. Hoffren M, Ishikawa M, Komi PV. Age-related neuromuscular function during drop jumps. Journal of Applied Physiology 2007; 103(4): 1276-1283.
  53. Onate JA, Guskiewicz KM, Sullivan RJ. Augmented feedback reduces jump landing forces. Journal of Orthopaedic & Sports Physical Therapy 2001; 31(9): 511-517.
  54. Wikstrom EA, Tillman MD, Chmielewski TL, Cauraugh JH,et al. Dynamic postural stability deficits in subjects with self-reported ankle instability. Medicine & Science in Sports & Exercise 2007; 39(3): 397-402.
  55. Nagai T, Sell TC, House AJ, Abt JP, et al. Knee proprioception and strength and landing kinematics during a single-leg stop-jump task. Journal of athletic training 2013; 48(1): 31-38
  56. Russell KA, Palmieri RM, Zinder SM, Ingersoll CD. Sex differences in valgus knee angle during a single-leg drop jump. Journal of athletic training 2006; 41(2): 166-178.
  57. Patrek MF, Kernozek TW, Willson JD, Wright GA, et al. Hip-abductor fatigue and single-leg landing mechanics in women athletes. Journal of athletic training 2011; 46(1): 31-42.
  58. Huber FE, Wells CL. Therapeutic exercise: Treatment planning for progression: Elsevier Saunders; 2006: 185-218
  59. Lee S-P, Souza RB, Powers CM. The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain. Gait & posture 2012; 36(3): 425-429.
  60. Kim M-K. Foot pressure analysis of adults with flat and normal feet at different gait speeds on an ascending slope. Journal of physical therapy science 2015; 27(12): 3767-3769.
  61. Lin C-J, Lai K-A, Kuan T-S, Chou Y-L. Correlating factors and clinical significance of flexible flatfoot in preschool children. Journal of pediatric orthopaedics. 2001;21(3):378-382.
  62. Konrad P. The ABC of EMG: A practical introduction to kinesiological electromyography. version 2005;1:29-33.
  63. Heiden TL, Lloyd DG, Ackland TR. Knee joint kinematics, kinetics and muscle co-contraction in knee osteoarthritis patient gait. Clinical biomechanics 2009; 24(10): 833-841.
  64. Park S, Kong Y-S, Ko Y-M, Jang G-U, et al. Differences in onset timing between the vastus medialis and lateralis during concentric knee contraction in individuals with genu varum or valgum. Journal of physical therapy science 2015; 27(4): 1207-1210.
  65. Nyland J, Smith S, Beickman K, Armsey T, et al. Frontal plane knee angle affects dynamic postural control strategy during unilateral stance. Medicine & Science in Sports & Exercise 2002; 34(7): 1150-1157.
  66. Witvrouw E, Danneels L, Thijs Y, Cambier D, et al. Does soccer participation lead to genu varum? Knee surgery, sports traumatology, arthroscopy 2009; 17(4): 422-427.
  67. Prentice WE. Rehabilitation techniques for sports medicine and athletic training with laboratory manual and esims password card.4 th edition. edition t, editor: McGraw-Hill Humanities/Social Sciences/Languages; 2004:17-73
  68. Orr R. Contribution of muscle weakness to postural instability in the elderly. A systematic review. European journal of physical and rehabilitation medicine. 2010; 46(2): 183-220.
  69. Javdaneh N, Minoonejad H, Shirzad E. The investigation of the muscle timing of anterior cruciate ligament agonist and antagonist muscles in athletes with hyper pronated feet 2016;  257-264.