太极拳调节膝关节内侧间室应力的作用及其相关机制研究

It is generally agreed that high abnormal knee joint loading can lead to knee osteoarthritis. Previous studies have shown that Taichi program can help to reduce symptoms of osteoarthritis knees, the mechanism behinds that might be the Taichi can help to correct the loading axis of the joint and improve the joint stability.Up to now, the kinetics, kinematics and kinesology research on Taichi program have been scarce. The purpose of our study is to investigate effectiveness of regulation mechanism of the Taichi program in medial compartment knee joint loading and the relationship between joint stability, loading, and muscle strength by using the 3D motion capture system and surface electromyography , which can help to understand the kinetics, kinematics and kinesology of lower extremity during performance Taichi. The results may help to explore the effectiveness of regulation mechanism of the Taichi program in medial compartemnt knee joint loading and provide the theoretical basis of Taichi in the treating of osteoarthritis knees in future.

膝关节受力模式异常作为膝骨关节炎发病的主要原因已受到普遍认同。过往大量研究证实太极拳能有效改善患者的临床症状，其内在机制可能与太极能够矫正膝关节的异常应力分布有关。但迄今为止仍缺乏基于对太极拳四方四隅各动作练习时的运动学、动力学及肌动学的量化研究。本项目拟以三维动作捕捉分析系统及表面肌电测试为技术手段，收集并分析太极拳四方四隅各动作练习过程中下肢的运动学、动力学肌及动学变化参数，研究其与关节稳定性、关节应力以及下肢肌肉力量间调控作用之间的相关性。探讨太极拳调节膝关节内侧间室应力的作用及其相关机制并为将来运用太极拳治疗膝骨关节炎提供客观可靠的理论依据。

本课题利用生物力学相关手段探讨了太极拳运动调节膝关节内侧间室应力分布的作用机制。研究结果表明，太极拳经典动作（倒卷肱，起势，搂膝拗步等）可以通过改变练习过程中足部的内外翻，内外旋变化，使足底中心压力轨迹向外侧偏移，进而使地面反作用力（冠状面）向同侧膝关节中心移动，减小膝关节中心与地面反作用力之间的垂直距离（膝关节内收力臂），并籍此减小膝关节内收力矩（External Knee Adduction Moment，EKAM）从而降低膝关节在冠状面上所承受的载荷。 综合上述结果，本研究为探讨太极拳运动中的经典动作对膝关节内侧间室应力的调控作用及其相关机制奠定了坚实的工作基础。同时对认识太极拳运动中的膝关节运动学，动力学变化之间的关系重要的启示性线索，并为应用太极拳治疗膝骨关节炎提供客观可靠的运动学及动力学研究依据，并为其进一步推广奠定扎实的生物力学理论基础。