首页|从运动生物力学角度探讨太极拳改善膝骨关节炎的作用机制

从运动生物力学角度探讨太极拳改善膝骨关节炎的作用机制

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膝骨关节炎(KOA)是一种多发于60周岁以上老年人的慢性退行性骨关节疾病.以太极拳为主的运动疗法已被证实对KOA所致慢性疼痛具有良好疗效,长期坚持太极拳锻炼可有效改善KOA患者膝踝本体感觉,增强动态稳定性和降低跌倒风险.但其具体机制尚未形成统一共识.KOA患者具有明显的运动生物力学特征改变,运动生物力学指标的改变是KOA的始动因素和病理基础.本研究基于运动生物力学探讨太极拳对KOA患者膝关节的力学影响,分析太极拳改善KOA的潜在作用机制,以期为太极拳干预KOA提供依据.太极拳训练涉及的运动生物力学理论包括动力学部分、静力学部分和运动学部分等.从运动生物力学角度看,太极拳训练改善KOA的潜在作用机制包括改善平衡能力、提高稳定性(改善KOA患者股四头肌肌力、协调膝关节周围肌群和降低KOA患者膝关节内侧负荷)、均衡关节内应力(降低半月板及软骨的峰值应力、改善下肢肌力和下肢力线)和降低运动反作用力等4个方面.但太极拳训练仍存在一些不足之处,可能会影响其运动生物力学的分析,具体表现在以下4个方面:① 太极拳初学者训练方式不恰当,可能会增加肌肉、韧带和关节损伤概率;② 太极拳训练动作具有一定难度,受试者短时间内学习容易动作不规范,容易影响研究数据的准确性;③ 脱落率逐渐提高,不利于进行数据统计;④ 完整的太极拳训练耗时长、分析难度大,目前主要单独对特定动作进行分析,关于非代表性动作的研究偏少.
Mechanism of Tai Chi Chuan in Improving Knee Osteoarthritis from the Perspective of Sports Biomechanics
Knee osteoarthritis(KOA)is a chronic degenerative joint disease that occurs mostly in the elderly over the age of 60.Exercise therapy,represented by Tai Chi Chuan,has been proven to have good effective in relieving chronic pain caused by KOA.Long-term practice of Tai Chi Chuan can effectively improve knee and ankle proprioception,enhance dynamic stability and reduce the risk of falls in patients with KOA.However,there is no unified consensus on the specific mechanism of Tai Chi Chuan.Patients with KOA have obvious changes in their biomechanical characteristics.The changes in biomechanical parameters are the initial factors and pathological basis of KOA.This study explores the mechanical effects of Tai Chi Chuan on the knee joint of pa-tients with KOA based on sports biomechanics and analyzes the potential mechanism of Tai Chi Chuan in improving KOA,in order to provide a theoretical basis for Tai Chi Chuan intervention in KOA.The theory of sports biomechanics involved in Tai Chi Chuan includes dynamic part,static part and kinematic part.From the perspective of sports biomechanics,the potential mechanism of Tai Chi Chuan to improve KOA includes four aspects:improving balance ability,improving stability(improving quadriceps muscle strength,coordinating muscle groups around the knee joint and reducing the medial load of the knee joint in patients with KOA),balancing intra-articular stress(reducing the peak stress of meniscus and cartilage,improving lower limb muscle strength and lower limb alignment)and reducing movement reaction force.However,there are still some inadequacies in Tai Chi Chuan practice,which may affect the analysis of sports biomechanics,specifically manifest in the following four aspects:(1)The training method for Tai Chi Chuan beginners may not be appropriate,which may increase the probability of muscle,ligament and joint injuries.(2)Tai Chi Chuan training movements are difficult.Subjects tend to have nonstandard movements when they learn in a short time,which easily affects the accuracy of research data.(3)The gradual increase of dropout rate is not conducive to data statistics.(4)Complete Tai Chi Chuan is time-consuming and difficult to analyze individually.At present,representative movements are mainly analyzed,and research on non-representative movements is scarce.

knee osteoarthritisTai Chi Chuansports biomechanicsbalance abilitystabilityintra-articular stressreaction force

刘龙呈、张峰、高鹏翼、赵天林、王泓皓、李刘伊诺、王佳颖、朱翔宇

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北京中医药大学针灸推拿学院,北京 100029

膝骨关节炎 太极拳 运动生物力学 平衡能力 稳定性 关节内应力 运动反作用力

教育部产学研项目北京中医药大学重点攻关课题项目

2021013120012020-JYB-ZDGG-066

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(4)
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