超重肥胖对儿童跑步时膝关节生物力学的影响

杨海英; 付常喜; 何瑞波; 马刚

doi:10.16835/j.cnki.1000-9817.2022.04.021

超重肥胖对儿童跑步时膝关节生物力学的影响

doi: 10.16835/j.cnki.1000-9817.2022.04.021

1.
中国矿业大学徐海学院公共体育部，江苏徐州 221008
2.
徐州工程学院体育学院
3.
中国人民武装警察部队后勤学院卫生勤务系军事训练医学教研室

基金项目:

天津市重点实验室开放基金项目 SY-04-20203-004

江苏省教育科学“十四五”规划课题项目 T-C/2021/14

武警后勤学院基础科研项目 WHJ202106

详细信息

作者简介:
杨海英(1982-)，男，黑龙江五大连池人，硕士，讲师，主要研究方向为运动健康促进

通讯作者:
马刚，E-mail：sdsgmg@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 G806 G804.49
计量
- 文章访问数: 711
- HTML全文浏览量: 281
- PDF下载量: 39
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-27
- 修回日期: 2022-03-11
- 网络出版日期: 2022-04-25
- 刊出日期: 2022-04-25

Impact of overweight and obesity on knee joint biomechanics during running in children

1.
Public Physical Education Department of Xuhai College, China University of Mining Technology, Xuzhou (221008), Jiangsu Province, China

摘要

摘要: 目的探讨超重肥胖对儿童跑步时膝关节生物力学的影响，为超重肥胖儿童科学制定运动处方并降低运动损伤风险提供理论支持。方法 2020年6—8月，选取江苏省徐州市某小学7~11岁正常体重(健康组)和超重肥胖(超重肥胖组)儿童各15名。受试者以[3.5×(1-5%)~3.5×(1+5%)]m/s的速度跑过测力平台，利用Simi Motion动作捕捉系统和Kistler三维测力平台同步采集膝关节运动学与动力学数据，采用外周定量计算机断层扫描测定胫骨平台表面积和密度。对比两组膝关节角度以及基于胫骨平台维度的冲击力学与膝关节力矩的差异。结果超重肥胖组跑步时支撑相膝关节外展峰值角度[(6.14±4.16)°]高于健康组[(2.57±1.36)°](t=-3.16，P < 0.01)；基于胫骨平台密度标准化后，超重肥胖组的冲击力学(垂直地面反作用力峰值、冲击峰值、最大负载率及平均负载率)与膝关节力矩(膝关节屈膝力、伸展力、内收力矩峰值)均高于健康组(t值分别为-4.26，-4.52，-2.97，-2.74；-2.17，-4.27，-3.70，P值均 < 0.05)。结论超重肥胖儿童表现出异常的跑步力学和膝关节负荷模式，跑步时支撑相膝关节承受较大负荷，可能增加前交叉韧带损伤或骨关节炎的发生风险。
- 超重 /
- 肥胖症 /
- 运动活动 /
- 膝关节 /
- 儿童
Abstract: Objective To investigate the impact of overweight and obesity on knee joint biomechanics during running in children and to provide theoretical support for scientific exercise prescription and reduced risk of exercise injury in overweight and obese children. Methods Fifteen children aged 7-11 years old with normal weight (healthy group) and overweight/obesity (overweight/obesity group) were selected from June to August 2020. Participants ran through the force measuring platform at a speed of [3.5×(1-5%)~3.5×(1+5%)]m/s. The kinematic and dynamic data of the knee joint were collected simultaneously by the Simi Motion motion capture system and the Kistler three-dimensional force measuring platform, and the surface area and density of the tibial plateau were measured by peripheral quantitative computed tomography. The difference of knee joint angle, impact mechanics and knee joint torque based on tibial plateau dimension were compared between the two groups. Results The knee abduction peak angle of the overweight/obesity group[(6.14±4.16)°] was higher than that of the healthy group[(2.57±1.36)°] (t=-3.16, P < 0.05). Based on the standardization of tibial plateau dimension, the impact mechanics (peak vertical ground reaction force, peak impact force, maximum load rate and average load rate) and knee joint torque (knee flexion, extension, adduction peak torque) in the overweight/obesity group were higher than those in the healthy group (t=-4.26, -4.52, -2.97, -2.74, -2.17, -4.27, -3.70, P < 0.05). Conclusion Overweight/obese children show abnormal running mechanics and knee joint load. Higher joint load may indicate increased risk of anterior cruciate ligament injury among overweight/obese children.
- Overweight /
- Obesity /
- Motor activity /
- Knee joint /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 健康组和超重肥胖组儿童胫骨平台密度和表面积比较(x±s)

Table 1. Comparison of tibial plateau density and surface area between healthy group and overweight/obese group(x±s)

组别	人数	胫骨平台密度/ (mg·cm^-3)	体重与胫骨平台密度比值/[kg· (mg·cm^-3)^-1]	胫骨平台表面积/mm²	体重与胫骨平台表面积比值/ (kg·mm^-2)
健康组	15	196.41±30.80	0.16±0.03	1 257.32±372.30	0.03±0.01
超重肥胖组	15	183.47±25.41	0.25±0.05	1 393.06±521.58	0.04±0.02
t值		1.26	-7.02	-0.82	-2.58
P值		0.22	< 0.01	0.42	0.02

下载: 导出CSV

表 2 健康组和超重肥胖组儿童冲击力学比较(x±s)

Table 2. Comparison of impact mechanics between healthy group and overweight and obese group(x±s)

组别	人数	垂直地面反作用力峰值				冲击峰值
组别	人数	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]
健康组	15	76.32±13.81	2.61±0.46	0.07±0.02	0.40±0.08	53.20±12.86	1.79±0.46	0.05±0.02	0.27±0.07
超重肥胖组	15	104.88±20.10	2.29±0.33	0.09±0.04	0.58±0.14	77.53±16.64	1.72±0.41	0.07±0.03	0.43±0.12
t值		-4.22	2.19	-1.71	-4.26	-4.46	0.44	-1.70	-4.52
P值		< 0.01	0.04	0.10	< 0.01	< 0.01	0.66	0.10	< 0.01

组别	人数	最大负载率				平均负载率
组别	人数	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]
健康组	15	2 719.62±516.74	91.80±19.77	2.35±0.84	14.28±3.82	2 234.05±425.68	75.33±15.02	1.93±0.67	11.79±3.60
超重肥胖组	15	3 449.35±854.27	77.58±24.51	2.96±1.77	18.91±4.90	2 856.83±648.04	63.04±14.35	2.42±1.30	16.14±4.77
t值		-2.83	1.75	-1.22	-2.97	-3.11	2.28	-1.30	-2.74
P值		0.01	0.09	0.24	0.01	< 0.01	0.03	0.21	0.01

下载: 导出CSV

表 3 健康组和超重肥胖组儿童膝关节力矩比较(x±s)

Table 3. Comparison of knee joint torque between healthy group and overweight and obese group(x±s)

组别	人数	膝关节屈膝力矩峰值				膝关节伸展力矩峰值
组别	人数	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]
健康组	15	9.16±3.61	0.31±0.13	0.01±0.00	0.05±0.02	47.61±8.73	1.60±0.31	0.04±0.02	0.25±0.06
超重肥胖组	15	11.63±3.87	0.26±0.09	0.01±0.01	0.07±0.02	64.02±10.18	1.43±0.33	0.06±0.03	0.36±0.08
t值		-1.81	1.34	-1.05	-2.17	-4.72	1.51	-1.32	-4.27
P值		0.08	0.19	0.30	0.04	< 0.01	0.14	0.20	< 0.01

组别	人数	膝关节内收力矩峰值				膝关节外展力矩峰值
组别	人数	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]	绝对值/N	体重标准化/ (N·kg^-1)	胫骨平台表面积标准化/(N·mm^-2)	胫骨平台密度标准化/ [N·(mg·cm^-3)^-1]
健康组	15	5.69±1.93	0.19±0.07	0.01±0.00	0.03±0.01	13.87±3.36	0.47±0.12	0.01±0.00	0.07±0.02
超重肥胖组	15	8.81±3.25	0.20±0.08	0.01±0.01	0.05±0.02	11.79±3.03	0.26±0.09	0.01±0.01	0.07±0.02
t值		-3.20	-1.11	-1.83	-3.70	1.78	5.33	0.89	0.78
P值		< 0.01	0.91	0.08	< 0.01	0.09	< 0.01	0.38	0.44

下载: 导出CSV

参考文献(16)

[1]	郭子予, 冯哲浩, 汪文新, 等. 中国学龄儿童超重肥胖流行特征及其干预对策[J]. 中国学校卫生, 2021, 42(11): 1747-1750. doi: 10.16835/j.cnki.1000-9817.2021.11.034 GUO Z Y, FENG Z H, WANG W X, et al. Epidemiological characteristics and intervention strategies of overweight and obesity among Chinese school-age children[J]. Chin J Sch Health, 2021, 42(11): 1747-1750. doi: 10.16835/j.cnki.1000-9817.2021.11.034
[2]	袁金娜, 金冰涵, 斯淑婷, 等. 2009—2019年6~15岁中国儿童超重和肥胖趋势分析[J]. 中华儿科杂志, 2021, 59(11): 935-941. YUAN J N, JIN B H, SI S T, et al. Changing prevalence of overweight and obesity among Chinese children aged 6-15 form 2009-2019[J]. Chin J Pediatr, 2021, 59(11): 935-941.
[3]	KOHUT T, ROBBINS J, PANGANIBAN J. Update on childhood/adolescent obesity and its sequela[J]. Curr Opin Pediatr, 2019, 31(5): 645-653. doi: 10.1097/MOP.0000000000000786
[4]	MONTES-ALGUACIL J, PÁEZ-MOGUER J, JIMÉNEZ CEBRIÁN A M, et al. The influence of childhood obesity on spatio-temporal gait parameters[J]. Gait Posture, 2019, 71: 69-73. doi: 10.1016/j.gaitpost.2019.03.031
[5]	KIM N, BROWNING R C, LERNER Z F. The effects of pediatric obesity on patellofemoral joint contact force during walking[J]. Gait Posture, 2019, 73: 209-214. https://pubmed.ncbi.nlm.nih.gov/31374438/
[6]	LEONARD M B, ZEMEL B S, WROTNIAK B H, et al. Tibia and radius bone geometry and volumetric density in obese compared to non-obese adolescents[J]. Bone, 2015, 73: 69-76. doi: 10.1016/j.bone.2014.12.002
[7]	国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 2018-08-01. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity in school-age children and adolescents: WS/T 586-2018[S]. 2018-08-01.
[8]	陆爱云. 运动生物力学[M]. 北京: 人民体育出版社, 2019: 175-193. LU A Y. Biomechanics of sports[M]. Beijing: People's Sports Press, 2019: 175-193.
[9]	SILVA M, DECHICHI P, LIMIRIO P. Impact of childhood obesity on bone metabolism[J]. Pediatr Endocrinol Rev, 2020, 17(4): 308-316.
[10]	VILLARRASA-SAPIÑA I, SERRA-AÑÓ P, PARDO-IBÁÑEZ A, et al. Relationship between body composition and vertical ground reaction forces in obese children when walking[J]. Clin Biomech (Bristol, Avon), 2017, 41: 77-81. doi: 10.1016/j.clinbiomech.2016.12.008
[11]	GKASTARIS K, GOULIS D G, POTOUPNIS M, et al. Obesity, osteoporosis and bone metabolism[J]. J Musculoskelet Neuronal Interact, 2020, 20(3): 372-381. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493444/
[12]	GEORGIEV T, ANGELOV A K. Modifiable risk factors in knee osteoarthritis: treatment implications[J]. Rheumatol Int, 2019, 39(7): 1145-1157. doi: 10.1007/s00296-019-04290-z
[13]	MCMILLAN A G, PULVER A M, COLLIER D N, et al. Sagittal and frontal plane joint mechanics throughout the stance phase of walking in adolescents who are obese[J]. Gait Posture, 2010, 32(2): 263-268. doi: 10.1016/j.gaitpost.2010.05.008
[14]	CREABY M W, WANG Y, BENNELL K L, et al. Dynamic knee loading is related to cartilage defects and tibial plateau bone area in medial knee osteoarthritis[J]. Osteoarthritis Cartilage, 2010, 18(11): 1380-1385. doi: 10.1016/j.joca.2010.08.013
[15]	HUDSON D, ROYER T, RICHARDS J. Bone mineral density of the proximal tibia relates to axial torsion in the lower limb[J]. Gait Posture, 2007, 26(3): 446-451. doi: 10.1016/j.gaitpost.2006.11.001
[16]	SHULTZ S P, SITLER M R, TIERNEY R T, et al. Effects of pediatric obesity on joint kinematics and kinetics during 2 walking cadences[J]. Arch Phys Med Rehabil, 2009, 90(12): 2146-2154. doi: 10.1016/j.apmr.2009.07.024