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下肢骨关节炎是导致残疾的最常见疾病之一,也是对患者及家庭、医疗系统及社会带来最大影响的运动系统的主要疾患。骨关节炎是包括关节力学变化(如下肢骨骼力学轴线排列异常,关节负荷分布异常,活动过程中关节力矩异常)、韧带走向异常、软骨退化或软骨成分降解和肌肉神经控制功能异常等复合因素引起的全关节疾患。尽管其确切的发病机制仍不明了,关节生物力学在其发生和病程发展中的作用已为大量的前瞻性研究和持续数10年之久的长期追踪研究所证实。综述骨关节炎生物力学及病理机制的研究状况,生物力学干预在骨关节炎治疗康复中的应用,以及太极拳的生物力学特征及其在骨关节炎治疗康复中应用的最新研究进展。基于目前上述领域和太极拳生物力学特征的科学研究状况分析,以及美国风湿病学会在2012年发表的最新骨关节炎非手术和药物治疗指引中将太极拳列为膝骨关节炎运动干预方式之一所带来的国际影响,为了深入探索太极拳在下肢骨关节炎治疗康复效果的机制,以及发展有科学研究事实支持的太极拳运动干预康复方案,未来此领域的研究需要致力于研究骨关节炎患者身体活动时的关节生物力学变化,典型太极拳运动的生物力学特征,以及骨关节炎患者在太极拳运动干预过程中下肢关节力学的变化特征。
Osteoarthritis of the lower extremities is one of the most common diseases that cause disability and is also a major condition of the exercise system that has the greatest impact on patients, their families, the medical system and society. Osteoarthritis is caused by a combination of factors including changes in joint mechanics (such as axial alignment of the lower extremity skeleton mechanics, abnormal joint load distribution, abnormal joint torque in the course of the activity), abnormal ligaments, degeneration of the cartilage or degradation of the cartilage components and dysfunction of the muscle nerves All-joint disorders. Although its exact pathogenesis remains unknown, the role of joint biomechanics in its development and progression has been confirmed by a large number of prospective studies and long-term follow-up studies that have persisted for decades. This paper reviews the research status of biomechanics and pathology of osteoarthritis, the application of biomechanical intervention in the treatment of osteoarthritis, and the biomechanical characteristics of Taijiquan and its application in the treatment of osteoarthritis. Based on the current state of scientific research on biomechanical characteristics of the field and tai chi, and the latest guidelines on non-surgical treatment of osteoarthritis and medical treatment published by the American College of Rheumatology in 2012, taijiquan is listed as a method of knee osteoarthritis exercise intervention In order to further explore the mechanism of Taijiquan treatment and rehabilitation of lower extremity osteoarthritis, as well as the development of Taijiquan exercise intervention and rehabilitation programs supported by the factual research of science, the research in this field needs to be devoted to the study of bone and joint Joint biomechanical changes during physical activity in inflamed patients, biomechanical characteristics of typical Taijiquan exercises, and changes of lower limb joint mechanics in patients with osteoarthritis during Taijiquan exercise intervention.