The work of the lower limb muscles under conditions of the knee flexible contract
Keywords:contracture of the knee joint, muscle strength, walking simulation
Background. Flexion contracture of the knee joint is a pathological condition that negatively affects the musculoskeletal function of the lower limb and significantly impairs the patient’s quality of life. A change in the natural anatomical relationships in one joint leads to a change in the load in the adjacent joints and provokes the development of degenerative changes. Purpose of the work: using a walking model to study the work of the muscles of the lower limb in conditions of knee joint contracture of varying severity. Determine the minimum required muscle strength of the lower limb for a normal stride. Materials and methods. Muscle dysfunction in contractures of the knee joint was investigated, which was modeled by limiting the extension of the hip to 10°, 15° and 20°. The analysis was carried out for the muscles of the right lower limb, comparing the obtained indicators with the indicators of the base model (the same limb without limitation of extension). Results. Contracture of the knee joint not only disrupts the function of the knee joint itself, but also, due to the versatility of the work of most of the two-joint muscles of the thigh and lower leg, pathologically affects the function of the hip and ankle joints. The extensors of the lower leg suffer more than others with contractures of the knee joint. This is due to the fact that in order to ensure correct gait, full extension of the lower leg is necessary, and these muscles need to develop strength that can overcome contracture. For example, with a 20° contracture for knee extension, the model should develop a force of 2250 N, but in reality, according to Delp (1990), the maximum possible isometric force is 780 N, which is almost 3 times less. Semitendinosus is one of the muscles that most of all affects the functionality of the hip joint; its obvious overstrain can be traced in the models. The work of m. gracilis and m. sartorius is significantly disrupted. With the excess of their functional capabilities in contractures of the knee joint,
m. biceps femoris – short head. The maximum tension that this muscle is able to develop is 400 N, while in models with contractures of the knee joint the force required for normal walking reaches 900 N, which naturally the muscle is not able to develop in real conditions. Conclusions. Contracture of the knee joint leads to a change in the biomechanics of the entire lower limb. Limiting the mobility of the knee joint leads to an increase in changes in the work of the muscles, forcing them to work either under conditions of constant tension or, conversely, turning them off from work, which leads to a sharp violation of the gait. Knowing the effect of contracture of the knee joint on the work of the muscles of the lower limb, it is possible to predict the course of the development of the pathological process, to determine which muscle groups are most affected. Taking into account the peculiarities of their functioning with varying degrees of limitation of the knee joint mobility, it is possible to determine which muscle group needs correction before and after surgery.
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