ارتباط الگوهای هم انقباضی کوادریسپس و همسترینگ با زاویه والگوس زانو در زنان ورزشکار حرفه ای

نوع مقاله: مقاله پژوهشی

نویسندگان

1 استادیار حرکات اصلاحی و آسیب شناسی ورزشی دانشگاه بوعلی سینا، همدان، ایران

2 استاد حرکات اصلاحی و آسیب شناسی ورزشی دانشگاه تهران، ایران

3 دانشیار حرکات اصلاحی و آسیب شناسی ورزشی دانشگاه تهران، ایران

4 دانشیار گروه ارگونومی دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

5 استادیار حرکات اصلاحی و آسیب شناسی ورزشی دانشگاه تهران، ایران

6 کارشناس ارشد بیومکانیک ورزشی، تهران، ایران

چکیده

زمینه و هدف: زاویه والگوس زانو یکی از عوامل پیش­بین آسیب­های غیربرخوردی لیگامان صلیبی قدامی (ACL) است. هدف تحقیق حاضر بررسی ارتباط بین الگوهای هم انقباضی کوادریسپس و همسترینگ با زاویه والگوس زانو در زنان ورزشکار حرفه­ای بود.  
روش شناسی: 56 زن ورزشکار (با میانگین ± انحراف استاندارد سن 99/1 ±15/20 سال ; قد 25/7 ±28/169 سانتیمتر; وزن 06/10 ±05/60 کیلوگرم) به عنوان آزمودنی در پژوهش شرکت کردند. فعالیت الکترومیوگرافی مدیال و لترال کوادریسپس و همسترینگ و کینماتیک اندام تحتانی حین فرود- پرش ثبت شد. شاخص هم­انقباضی مدیال و لترال کوادریسپس- همسترینگ، نسبت هم­انقباضی مدیال به لترال زانو و زاویه والگوس زانو در لحظه تماس پا با زمین محاسبه و در تحلیل داده­ها مورد استفاده قرار گرفت. برای تعیین ارتباط بین الگوهای هم­انقباضی با زاویه والگوس زانو در لحظه تماس پا با زمین از آزمون همبستگی پیرسون استفاده شد (P≤0.05).
یافته­ ها: یافته­های تحقیق نشان داد بین شاخص هم­انقباضی مدیال کواردیسپس- همسترینگ (001/0 p=) و نسبت هم­انقباضی مدیال به لترال زانو (001/ 0p=) با زاویه والگوس زانو همبستگی معنی­دار وجود دارد. نتایج پژوهش همچنین نشان داد بین شاخص هم­انقباضی لترال کواردیسپس- همسترینگ با زاویه والگوس زانو همبستگی معنی دار وجود ندارد (799/0 p=).
نتیجه­ گیری: بنظر می­رسد زنان ورزشکار هم­انقباضی مدیال به لترال کواردیسپس- همسترینگ نامتعادلی دارند، که توانایی مقابله با بارهای ابداکشن را محدود می­کند. از آنجا که افزایش لود ابداکشن باعث افزایش استرین روی ACL می­شود، به تعادل رساندن هم­انقباضی در بخش مدیال و لترال زانو می­تواند به کاهش آسیب­های ACL کمک کند.
 

کلیدواژه‌ها


عنوان مقاله [English]

Association of quadriceps and hamstrings cocontraction patterns with knee valgus angle in professional female athletes

نویسندگان [English]

  • . . 1
  • . . 2
  • . . 3
  • . . 4
  • . . 5
  • . . 6
1 .
3 .
4 .
5 .
6 .
چکیده [English]

Background and purpose: knee valgus angle (KVA) maybe a predictor of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to investigate the relationship between quadriceps and hamstrings cocontraction patterns with knee valgus angle in professional female athletes.  
Methodology: Fifty-six female athletes (mean ± SD age, 20.5 ± 1.99 years; height, 169.28 ± 7.25 cm; body mass, 60.05 ± 10.06 kg) participated. Surface electromyographic data from the medial and lateral hamstrings and quadriceps and lower extremity kinematics were recorded during the drop jump task. Lateral and medial quadriceps-to-hamstrings (Q:H) cocontraction indices, the ratio of medial-to- lateral Q:H cocontraction, normalized root mean square electromyographic data for medial and lateral quadriceps and hamstrings, and knee valgus angle at initial contact were calculated and used in data analyses. Pearson correlation analyses were performed to determine the relationships between quadriceps and hamstrings cocontraction patterns and knee valgus angle at initial contact (P≤0.05).
Results: Medial quadriceps-to-hamstrings (Q: H) cocontraction indices and the ratio of medial-to- lateral Q: H cocontraction were found to be correlated with knee valgus angle (P = 0.001 and P = 0.000, respectively).  No correlation between lateral Q: H cocontraction and knee valgus angle was found (P = 0.799).
Conclusion: Medial-to-lateral Q: H cocontraction appears to be unbalanced in female athletes, which may limit their ability to resist abduction loads. Because higher abduction loads increase strain on the ACL, restoring medial-to-lateral Q: H cocontraction balance in women may help reduce ACL injury risk.
 

کلیدواژه‌ها [English]

  • ACL injury
  • neuromuscular risk factor
  • cocontraction
  • drop jump
##Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, DeMaio M, et al. Understanding and preventing noncontact anterior cruciate ligament injuries. The American journal of sports medicine. 2006;34(9):1512-32.## Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training. 2007;42(2):311-9.## Yu B, Kirkendall D, Taft T, Garrett Jr W. Lower extremity motor control-related and other risk factors for noncontact anterior cruciate ligament injuries. Instructional course lectures. 2001;51:315-24.## Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understandin and prevention ACL injuries: current biomechanical and epidemiological consideration. North American journal of sports physical therapy. 2010;5(4):234-51.## Mihata LCS, Beutler AI, Boden BP. Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players implications for anterior cruciate ligament mechanism and prevention. The American journal of sports medicine. 2006;34(6):899-904.## Shimokochi Y, Shultz SJ. Mechanisms of noncontact anterior cruciate ligament injury. Journal of Athletic Training. 2008;43(4):396-408.## Boden BP, Sheehan FT, Torg JS, Hewett TE. Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. Journal of the American Academy of Orthopaedic Surgeons. 2010;18(9):520-7.## Kessler M, Behrend H, Henz S, Stutz G, Rukavina A, Kuster M. Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment. Knee Surgery, Sports Traumatology, Arthroscopy. 2008;16(5):442-8.## Mihelic R, Jurdana H, Jotanovic Z, Madjarevic T, Tudor A. Long-term results of anterior cruciate ligament reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years. International orthopaedics. 2011;35(7):1093-7.## Smith HC, Vacek P, Johnson RJ, Slauterbeck JR, Hashemi J, Shultz S, et al. Risk Factors for Anterior Cruciate Ligament Injury. Sports Health: A Multidisciplinary Approach. 2012;4(1):69-78.## Gilchrist J, Mandelbaum BR, Melancon H, Ryan GW, Silvers HJ, Griffin LY, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. The American journal of sports medicine. 2008;36(8):1476-83.## Hollman JH, Galardi CM, Lin I, Voth BC, Whitmarsh CL. Frontal and transverse plane hip kinematics and gluteus maximus recruitment correlate with frontal plane knee kinematics during single-leg squat tests in women. Clinical Biomechanics. 2014:(inpress).## MagalhãEs E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ. A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2010;40(10):641-7.## Hewett TE, Myer GD, Ford KR, Heidt Jr RS, Colosimo AJ, McLean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. The American journal of sports medicine. 2005;33(4):492-501.## Claiborne TL, Armstrong CW, Gandhi V, Pincivero DM. Relationship between hip and knee strength and knee valgus during a single leg squat. Journal of applied biomechanics. 2006;22(1):41-50.## Sigward SM, Ota S, Powers CM. Predictors of frontal plane knee excursion during a drop land in young female soccer players. The Journal of orthopaedic and sports physical therapy. 2008;38(11):66-71.## Lloyd DG, Buchanan TS. Strategies of muscular support of varus and valgus isometric loads at the human knee. Journal of biomechanics. 2001;34(10):1257-67.## Zhang L-Q, Wang G. Dynamic and static control of the human knee joint in abduction–adduction. Journal of biomechanics. 2001;34(9):1107-15.## Myer GD, Ford KR, Hewett TE. The effects of gender on quadriceps muscle activation strategies during a maneuver that mimics a high ACL injury risk position. Journal of Electromyography and Kinesiology. 2005;15(2):181-9.## Rozzi SL, Lephart SM, Gear WS, Fu FH. Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players. The American journal of sports medicine. 1999;27(3):312-9.## Palmieri-Smith RM, McLean SG, Ashton-Miller JA, Wojtys EM. Association of quadriceps and hamstrings cocontraction patterns with knee joint loading. Journal of Athletic Training. 2009;44(3):256-63.## Palmieri-Smith RM, Wojtys EM, Ashton-Miller JA. Association between preparatory muscle activation and peak valgus knee angle. Journal of Electromyography and Kinesiology. 2008;18(6):973-9.## Nguyen AD, Boling MC, Levine B, Shultz SJ. Relationships between lower extremity alignment and the quadriceps angle. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 2009;19(3):201-6.## Nguyen AD, Shultz SJ. Sex differences in clinical measures of lower extremity alignment. The Journal of orthopaedic and sports physical therapy. 2007;37(7):389-398.## Daneshmandi H, Saki F. The Study of Joint Hypermobility and Q Angle in Female Football Players. World Journal of Sport Science. 2010;3(4):243-7.## Daneshmandi H, Saki F, Shahheidari S, Khoori A. Lower extremity Malalignment and its linear relation with Q angle in female athletes. Procedia-Social and Behavioral Sciences. 2011;15:3349-54.## Daneshmandi H, Saki F, Daneshmandi L, Daneshmandi MS. Lower extremity alignment in female athletes with ACL reconstruction. Medicina dello Sport. 2012;65(2):211-21.## Daneshmandi H, Saki F. The study of static lower extremity alignment in female athletes with ACL injury . Journal of Sports Science and Medicine Suppl. 2009;11:73-75.## Shultz SJ, Nguyen AD, Schmitz RJ. Differences in lower extremity anatomical and postural characteristics in males and females between maturation groups. The Journal of orthopaedic and sports physical therapy. 2008;38(3):137-49.## Shultz SJ, Nguyen AD, Leonard MD, Schmitz RJ. Thigh strength and activation as predictors of knee biomechanics during a drop jump task. Medicine and science in sports and exercise. 2009;41(4):857-66.## Konrad P. The ABC of EMG.A Practical Introduction to Kinesiological Electromyography 2005. ## Ford KR, Myer GD, Hewett TE. Valgus knee motion during landing in high school female and male basketball players. Medicine & Science in Sports & Exercise. 2003;35(10):1745-50.## Kadaba MP, Ramakrishnan H, Wootten M. Measurement of lower extremity kinematics during level walking. Journal of Orthopaedic Research. 2005; 8(3): 383-92.## Blackburn JT, Padua DA. Influence of trunk flexion on hip and knee joint kinematics during a controlled drop landing. Clinical Biomechanics. 2008;23(3):313-9.## Kellis E. Quantification of quadriceps and hamstring antagonist activity. Sports Medicine. 1998;25(1):37-62.## De Luca CJ, Erim Z. Common drive in motor units of a synergistic muscle pair. Journal of neurophysiology. 2002;87(4):2200-4.## Gardinier ES. The Relationship Between Muscular Co-Contraction and Dynamic Knee Stiffness in ACL-Deficient Non-Copers: 2009. University of Delaware.## Tsai LC, McLean S, Colletti PM, Powers CM. Greater muscle co‐contraction results in increased tibiofemoral compressive forces in females who have undergone anterior cruciate ligament reconstruction. Journal of Orthopaedic Research. 2012;30(12):
2007-14.## Setton L, Mow VC, Howell D. Mechanical behavior of articular cartilage in shear is altered by transection of the anterior cruciate ligament. Journal of Orthopaedic Research. 1995;13(4):473-82.## Boden BP, Griffin LY, Garrett W. Etiology and prevention of noncontact ACL injury. Physician and Sports Medicine. 2000;28(4):53-62.## 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):347-50.## Lloyd DG, Buchanan TS, Besier TF. Neuromuscular biomechanical modeling to understand knee ligament loading. Medicine and science in sports and exercise. 2005;37(11):1939-47.## Chmielewski TL, Hurd WJ, Rudolph KS, Axe MJ, Snyder-Mackler L. Perturbation training improves knee kinematics and reduces muscle co-contraction after complete unilateral anterior cruciate ligament rupture. Physical Therapy. 2005;85(8):740-9.## Letafatkar A. Effects of perturbation-enhance training on knee flexion angle and hamstring and quadriceps electromyography during landing in active subjects with neuromuscular quadriceps dominance deficit: 2014, university of Tehran.## Neumann DA. Kinesiology of the hip: a focus on muscular actions. journal of orthopaedic & sports physical therapy. 2010;40(2):82-94.##