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1 ,. 選択反応によるサイドステップカット動作中の膝関節運動について Effect of choice reaction on knee joint kinematics during sidestep cutting maneuvers Kenji KIMURA Shinji SAKURAI Abstract Previous studies on the kinetics of sidestep cutting movement reported that the external moment of knee joint was larger under an unanticipated (UN) condition than a preplanned (PRE) condition. The purpose of this study was to compare the lower limb joint kinematics in sidestep cutting maneuvers in the first half of the foot contact phase between UN and PRE conditions. A VICON motion analysis system using ten cameras (125Hz) was used to determine the lower limb joint kinematics of 8 healthy male subjects during sidestep cutting tasks performed under the UN and PRE conditions. Knee flexion angle and anterior tibial draw at initial foot contact were smaller under the UN condition than the PRE condition (UN: 27.4±10.0deg; PRE: 38.1±10.6deg and UN: 0.9±0.5cm, PRE: 1.3±0.6cm, respectively). Knee valgus angle at minimum running speed in the foot contact phase was larger under the UN condition than the PRE condition (UN: 7.0±1.8deg; PRE: 4.9±2.9deg). Subjects tended to turn their lower trunk in the direction of travel after cutting earlier under the PRE condition, and the angle of pelvis in horizontal plane at first half in foot contact phase was significantly smaller (UN: 10.3±10.6deg; PRE: 20.6±10.4deg) under the UN condition than the PRE condition. Previous research on the knee joint stiffness based on cadaveric studies reported that the combination of the knee valgus load and anterior tibial drawer force increased the anterior cruciate ligament tensile force. In the present study, we found that the knee valgus Graduate School of Health and Sport Sciences, Chukyo University School of Health and Sport Sciences, Chukyo University [email protected]

The purpose of this study was to compare the lower limb joint kinematics in sidestep cutting maneuvers in the first half of the foot contact phase between UN and PRE conditions.

2 angle and anterior tibial draw in the first half of the foot contact phase were larger under the UN condition. The results in the present investigation suggest that sidestep cutting under the UN condition increases the risk of knee joint injuries. Key words Unanticipated condition, knee joint injuries, knee joint coordinate system キーワード 1. はじめに Andrews et al. ACL Chappell et al., ; Yu et al., ; Boden et al., Agel et al. ACL % noncontact noncontact ACL Cerulli et al. ACL GRF ACL Besier et al. a Besier et al. b, Unanticipated UN Preplanned PRE UN PRE

Key words Unanticipated condition, knee joint injuries, knee joint coordinate system キーワード 1. はじめに Andrews et al. ACL Chappell et al.

3 ACL Fleming et al., ; Markolf et al.,. Besier et al., a; b 2. 方法 2. 1 被検者.... m.. kg 2. 2 実験環境および機器設備. m. m Multi-Pas System PC Z G Foot Switch Y G R G 0.90m 0.45m 3.00m 60 LED Signal Running Direction X G 3.00m Photo Cell (hight 0.6m) VICON-MX cameras Fig. DKH LED LED LED LED UN PRE UN m. m. m Multi-Pas System, DKH

90m 0.45m 3.00m 60 LED Signal Running Direction X G 3.00m Photo Cell (hight 0.

4 LED Fig. VICON- MX VICON Nexus, Oxford Metrics mm mm LR AS PS MTH LTH MTB LTB TT TG LM MM TO M CT Fig.. RLTH RLTB RTT RAS RM5 RTO RTG RLM RPS RCT LCT LPS LMTH RMTH RMTB LMTB LTG RMM LMM LLTH LLTB LTT LLM LTO LM5 LAS 2. 3 分析身体位置データの処理 UN PRE Yu et al.,. Hz キネマティクス RG X Y Y Z X Z Fig. RP RF RT Fig. CH Vaughan RP CT cm TO cm

5 Z KJ X KJ X KJ R KJ Z P X P RPS LPS Y KJ Knee Joint Coordinate System (R KJ) Y KJ RAS CH R P LAS Z KJ Y P Z F X F RLTH RLTB R F Y F RMTH RMTB Z T RLTH RMTH Z KJ X T R T RLM H Y T RMTB Z G X KJ R KJ X G R G RLM RMM anterior/posterior direction H compression/distraction lateral/medial direction Y KJ Y G Grood and Suntay RKJ Fig. XKJ MTH LTH ZKJ MTB LTB MM LM XKJ ZKJ YKJ YF YKJ XT YJK XF ZT MTH LTH MTB LTB H RKJ XKJ YKJ ZKJ RP RF X-Y'-Z'' Kadaba et al., RP RF X Y' Z'' Fig. X-Y

direction H compression/distraction lateral/medial direction Y KJ Y G Grood and Suntay RKJ Fig.

6 統計処理 UN PRE t-test % 3. 結果 3. 1 サイドステップカット中の走行スピードと接地時間 UN PRE Table PRE UN.. m/s PRE.. m/s UN PRE UN.. m/s PRE.. m/s UN UN.. m/s PRE.. m/s UN UN PRE UN.. PRE.. UN.. PRE.. UN PRE 3. 2 接地期前半における膝関節まわりの回転運動 ACL Chappell et al., ; Yu et al., ; Boden et al., Table PRE UN.. PRE.. UN PRE At Initial Foot Contact At Minimum Running Speed Unanticipated Preplanned Unanticipated Preplanned Running Speed (m/s) 2.52(±0.28) 3.52 (±0.32) 1.68 (±0.37) 3.23(±0.31) Unanticipated Preplanned Duration of Foot Contact (s) 0.32(±0.07) 0.20 (±0.02) Duration of Pre Foot Contact (s) 0.34(±0.07) 0.23 (±0.05)

52(±0.28) 3.52 (±0.32) 1.68 (±0.37) 3.23(±0.31) Unanticipated Preplanned Duration of Foot Contact (s) 0.32(±0.07) 0.20 (±0.

7 UN: r -., PRE: r = -., p>. UN PRE PRE UN.. PRE.. UN PRE UN: r -., PRE: r =., p>. UN PRE Fig. At Initial Foot Contact At Minimum Running Speed Unanticipated Preplanned Unanticipated Preplanned Flexion Angle (deg) 27.4 (±10.0) 38.1 (±10.6) 60.2 (±7.7) 56.8 (±4.4) External Rotation Angle (deg) -0.2 (±5.9) 0.6 (±3.2) -0.1 (±5.9) 0.2(±4.3) Valgus Angle (deg) 4.8 (±2.7) 4.4 (±2.4) 7.0 (±1.8) 4.9 (±2.9) Lateral Tibial Shift (cm) 0.3 (±0.3) 0.3 (±0.2) 0.3 (±0.2) 0.2 (±0.2) Anterior Tibial Draw (cm) 0.9 (±0.5) 1.3 (±0.6) 2.0 (±0.5) 2.2(±0.7) Joint Distraction (cm) 0.4 (±0.5) 0.2 (±0.7) -0.1 (±0.7) -0.2 (±0.7)

2 (±7.7) 56.8 (±4.4) External Rotation Angle (deg) -0.2 (±5.9) 0.6 (±3.2) -0.1 (±5.9) 0.2(±4.3) Valgus Angle (deg) 4.8 (±2.7) 4.4 (±2.4) 7.0 (±1.8) 4.

8 3. 3 接地期前半における大腿骨に対する脛骨の並進移動距離 Table UN PRE UN.. cm PRE.. cm UN PRE UN: r., PRE: r = -., p>. PRE PRE: r., p<., UN: r =., p>. UN UN: r., p<., PRE: r =., p>. UN PRE 3. 4 接地期前半における股関節角度と水平面の骨盤の回転角 Table PRE UN.. PRE.. PRE UN.. PRE.. UN.. PRE.. UN PRE 4. 考察 UN PRE / PRE UN At Initial Foot Contact At Minimum Running Speed Unanticipated Preplanned Unanticipated Preplanned Flexion Angle (deg) 33.9 (±6.8) 46.7 (±9.5) 38.4 (±6.6) 41.4 (±7.0) Internal Rotaion Angle (deg) 10.2 (±8.2) 6.9 (±9.0) 10.8 (±7.5) 8.2 (±8.4) Abduction Angle (deg) 12.4 (±6.1) 7.8 (±4.3) 12.4 (±5.4) 8.4 (±6.0) Direction Angle of Pelvis (deg) 11.4 (±8.0) 16.6 (±9.3) 10.3 (±10.6) 20.6 (±10.4)

考察 UN PRE / PRE UN At Initial Foot Contact At Minimum Running Speed Unanticipated Preplanned Unanticipated Preplanned Flexion Angle (deg) 33.9 (±6.8) 46.7 (±9.5) 38.4 (±6.

9 Rand and Ohtsuki Besier et al. b UN PRE.. p<. Sanderson et al., UN PRE Besier et al. a, b Peak Push Off PRE Peak Push Off. PRE PRE UN Besier et al., ACL Yu et al., Pflum et al., landing ACL UN PRE Tab. PRE

10 UN Benoit et al., ; Reinschmidt et al., ; Lafortune et al., Markolf et al. ACL. ACL ACL ACL 5. 結論 ACL 文献 Agel J., Arendt, E. A., and Bershadsky B. Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer. Am. J. Sports Med. : -. Andrews, J. R., McLeod, W. D., Ward T. and Howard K. The cutting mechanism. Am. J. Sports Med. : -. Benoit, D. L., Ramsey, D. K.,Lamontagne M., Xu L., Wretenberg P. and Renstroem P. Effect of skin movement artifact on knee kinematics during gait and cutting motions measured in vivo. Gait and Posture : -. Besier, T. F., Lloyd, D. G., Cochrane, J. L. and Ackland, T. R. a External loading of the knee joint during running and cutting maneuvers. Med. Sci. Sports Exerc. : -. Besier, T. F., Lloyd, D. G., Ackland, T. R. and Cochrane, J. L. b Anticipatory effects on knee joint loading during running and cutting maneuvers. Med. Sci. Sports Exerc. : -. Besier, T. F., Lloyd, D. G. and Ackland, T. R. Muscle activation strategies at the knee during running and cutting maneuvers. Med. Sci. Sports Exerc. : -.

Am. J. Sports Med. : -. Benoit, D. L., Ramsey, D. K.,Lamontagne M., Xu L., Wretenberg P. and Renstroem P.

11 Boden, B. P., Dean, G. S., Feagin, J. A. Jr. and Garrett, W. E. Jr. Mechanisms of anterior cruciate ligament injury. Orthopedics : -. Cerulli G., Benoit, D. L., Lamontagne M., Caraffa A. and Liti A. In vivo anterior cruciate ligament strain behaviour during rapid deceleration movement: case report. Knee Surg. Sports Traumatol Arthrosc. : -. Fleming, B. C., Renstrom, P. A., Beynnon, B. D., Engstrom B., Peura, G. D., Badger G. J. and Johnson, R. J. The effect of weightbearing and external loading on anterior cruciate ligament strain. J. Biomech. : -. Grood, E. S. and Suntay, W. J. A joint coordinate system for the clinical description of threedimensional motions: application to the knee. J. Biomech. Eng. : -. Kadaba, M. P., Ramakrishnan, H. K. and Wootten, M. E. Measurement of lower extremity kinematics during level walking. J. Orthop. Res. : -. Lafortune, M. A., Cavanagh, P. R.,Sommer, H. J. III and Kalenak A Three-dimensional kinematics of the human knee during walking. J. Biomech. : -. Markolf, K. L., Burchfield, D. M., Shapiro, M. M., Shepard, M. F., Finerman, G. A. M. and Slauterbeck, J. L. Combined knee loading states that generate high anterior cruciate ligament forces. J. Orthop. Res. : -. Pflum, M. A., Shelburne, K. B., Torry, M. R., Decker, M. J. and Pandy, M. G. Model prediction of anterior cruciate ligament force during drop-landings. Med. Sci. Sports Exerc. : -. Rand, M. K. and Ohtsuki T. EMG analysis of lower limb muscles in humans during quick change in running directions. Gait and Posture : -. Reinschmidt C., van den Bogert, A. J., Nigg, B. M., Lundberg A. and Murphy N. Effect of skin movement on the analysis of skeletal knee joint motion during running. J. Biomech. : -. Sanderson, D. J., Franks, I. M. and Elliott D. The effects of targeting on the ground reaction forces during level walking. Human Movement Science : -. Vaughan, C. L., Davis, B. L. and O'Connor, J. C. Dynamics of human Gait nd Edition. Kiboho Publishers: Cape Town, South Africa, pp. -. Yu B., Lin, C. F. and Garrett, W. E. Lower extremity biomechanics during the landing of a stopjump task. Clin. Biomech. : -. Yu B., Gabriel D., Noble L. and An, K. N. Estimate of the optimum cutoff frequency for the butterworth low-pass digital filter. J. Appl. Biomech. : -.

, Engstrom B., Peura, G. D., Badger G. J. and Johnson, R. J. The effect of weightbearing and external loading on anterior cruciate ligament strain. J. Biomech. : -. Grood, E. S. and Suntay, W. J. A joint coordinate system for the clinical description of threedimensional motions: application to the knee.

The Most Effective Exercise for Strengthening the Supraspinatus : Evaluation by Magnetic Resonance Imaging by TAKEDA Yoshitsugu and ENDO Kenji Departm

The Most Effective Exercise for Strengthening the Supraspinatus : Evaluation by Magnetic Resonance Imaging by TAKEDA Yoshitsugu and ENDO Kenji Department of Orthopedic Surgery, The University of Tokushima