Mechanical loading of the patellofemoral joint and its correlation with various body mass indices in older adults practicing Tai Chi exercises

doi:10.12307/2026.166

Abstract

Abstract: BACKGROUND: As the aging population grows in China, overweight and obesity are increasingly leading to lower limb joint injuries in older adults.
OBJECTIVE: To compare the biomechanical data of the lower limb patellofemoral joint during Tai Chi movements and normal walking among older adults with different body mass indices, analyze the correlation between body mass index and biomechanical data of the lower limb patellofemoral joint, and investigate the impact of different body mass indices on the mechanical loading of the patellofemoral joint in older adults.
METHODS: The older adults with obesity (n=17), overweight (n=17), and normal body mass index (n=19) who had been practicing Tai Chi for an extended period were recruited based on body mass index classification. The VCION 3D infrared motion capture system and Kistler force measurement system were used to collect kinematic and dynamic data during typical Tai Chi movements and normal walking. A biomechanical model of the patellofemoral joint was established to calculate biomechanical parameters of the patellofemoral joint. The effects of body mass index on the mechanical characteristics of the patellofemoral joint during walking and Tai Chi in the older adults were quantified using analysis of variance and correlation analysis.
RESULTS AND CONCLUSION: (1) Compared with the normal group, patellofemoral joint force (P < 0.05) and peak patellofemoral joint contact area during normal walking (P < 0.05) and the knee flexion torque, patellofemoral joint force, and quadriceps muscle strength during Tai Chi movements were significantly decreased (P < 0.05) in the overweight and obesity groups. (2) The body mass index of the older adults was significantly negatively correlated with the peak knee flexion angle, peak patellofemoral contact area, and minimum patellofemoral joint contact area during the Tai Chi rolling arm movement (P < 0.05). The body mass index of the older adults was significantly negatively correlated with the peak knee flexion torque in the sagittal plane, peak patellofemoral joint force, minimum patellofemoral joint force, peak quadriceps force, maximum knee-joint angle, maximum patellofemoral contact area, and minimum patellofemoral contact area during the brush-knee and twist-step of Tai Chi movement (P < 0.05). The results suggest that as body mass index increases, dynamic loading on the patellofemoral joint in the lower limbs during Tai Chi movements decreases in the older adults. Compared to individuals with standard body mass, overweight and obese older adults exhibit a significant reduction in the peak force of the patellofemoral joint during Tai Chi brush knee and twist step, indicating lower dynamic loading on the patellofemoral joint of the lower limbs. Therefore, Tai Chi is recommended as a fitness exercise program for overweight and obese older individuals to prevent sports injuries from high mechanical loading on the lower limb joints.

Key words: patellofemoral joint force, older adults, obesity, Tai Chi, mechanical load, walking

CLC Number:

Li Guangmin, Wang Jiangna. Mechanical loading of the patellofemoral joint and its correlation with various body mass indices in older adults practicing Tai Chi exercises[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(24): 6182-6188.

Figures/Tables 7

2.4 髌股关节动态载荷在正常步行中，超重组、肥胖组的膝关节角度最大值(P < 0.05)、髌股关节接触面积最大值(P < 0.05)、髌股关节应力最小值(P < 0.05)、髌股关节接触面积最小值(P < 0.05)均显著小于正常组。在倒卷肱动作中，超重组、肥胖组的膝关节角度最大值(P < 0.05)、髌股关节接触面积最小值(P < 0.05)显著小于正常组。在搂膝拗步动作中，超重组、肥胖组的矢状面膝关节伸膝力矩最大值(P < 0.05)、髌股关节应力最大值(P < 0.05)、髌股关节反作用力最大值(P < 0.05)、股四头肌肌力最大值 (P < 0.05)、膝关节角度最大值(P < 0.05)、髌股关节接触面积最大值(P < 0.05)、髌股关节接触面积最小值均显著小于正常组(表2)。相比于步行，正常组与肥胖组人群倒卷肱、搂膝拗步动作中矢状面膝关节伸膝力矩最大值(P < 0.001)、髌股关节应力最大值(P < 0.05)、髌股关节应力最小值(P < 0.05)、髌股关节反作用力最大值(P < 0.05)、股四头肌肌力最大值(P < 0.05)、膝关节角度最小值(P < 0.05)均显著增大；超重组人群倒卷肱、搂膝拗步动作中矢状面膝关节伸膝力矩最大值(P < 0.001)、髌股关节应力最大值(P < 0.05)、髌股关节应力最小值(P < 0.05)、髌股关节反作用力最大值(P < 0.05)、股四头肌肌力最大值(P < 0.05)均显著增大(表2)。 3组老年人在正常步行、倒卷肱、搂膝拗步3个动作中，矢状面膝关节伸膝力矩、髌股关节应力、髌股关节反作用力、股四头肌肌力指标的各曲线呈现出相同的趋势，膝关节角度、髌股关节接触面积曲线趋势一致。在正常步行中，3组老年人矢状面膝关节伸膝力矩、髌股关节应力、髌股关节反作用力、股四头肌肌力曲线均呈现出“双峰双谷”的趋势，双峰分别出现在步行周期约15%，55%，双谷分别出现在步行周期约40%，95%；膝关节角度、髌股关节接触面积也呈现出“双峰一谷”的趋势，第一峰值出现在步行周期的15%，第二峰值非常突出，在步行周期70%；谷值与矢状面膝关节伸膝力矩、髌股关节应力、髌股关节反作用力、股四头肌肌力大致相同，分别出现在步行周期约40%，95%(图3)。倒卷肱动作中，3组老年人矢状面膝关节伸膝力矩、髌股关节应力、髌股关节反作用力、股四头肌肌力曲线均呈现出“前高后低”的趋势，在倒卷肱动作周期的20%-40%呈现出一个“峰值期”，在动作周期的60%-100%呈现大致平滑的“谷值期”；膝关节角度、髌股关节接触面积则呈现出“双峰一谷”趋势，峰值约出现在倒卷肱动作周期的30%，95%，“谷值期”则在倒卷肱动作周期的70%-85%(图4)。搂膝拗步动作中，矢状面膝关节伸膝力矩、髌股关节应力、髌股关节反作用力、股四头肌肌力均呈现“三峰三谷”趋势，其3个峰值分别出现在动作周期的15%，50%，85%，3个谷值分别出现在动作周期的30%，65%，90%；膝关节角度、髌股关节接触面积则呈现出“三峰两谷”趋势，3个峰值分别出现在动作周期的18%，50%，95%，两谷值约在动作周期的30%，65%；股四头肌肌力呈现出“前高后低”的趋势，在动作周期的20%-40%呈现出 “峰值期”，在动作周期的60%-100%呈现为“谷值期”(图5)。 2.5 髌股关节动态载荷与体质量指数的相关性相关分析结果显示，体质量指数与正常步行的膝关节角度最大值、髌股关节接触面积最大值、髌股关节接触面积最小值、髌股关节应力最小值，与倒卷肱动作的膝关节角度最大值、髌股关节接触面积最大值、髌股关节接触面积最小值，与搂膝拗步动作的矢状面膝关节伸膝力矩最大值、髌股关节反作用力最大值、髌股关节反作用力最小值、股四头肌肌力最大值、膝关节角度最大值、髌股关节接触面积最大值、髌股关节接触面积最小值均呈显著负相关(P < 0.05) (表3)。 2.6 不良事件试验过程中未发生不良事件。"

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