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开链运动 vs. 闭链运动
时间:2010/12/1 22:19:20
Open- vs. Closed-Kinetic Chain Exercise
 
lDistal segment is fixed or stabilized relative to proximal segment
lUsed more often in rehabilitation for lower extremity conditions
•Open Kinetic Chain Exercise (OKC)
lDistal segment is mobile and not fixed
 
•Both types of exercises have their place in the rehabilitation setting
The Concept of the Kinetic Chain
•Mechanical engineers described as link system
•In closed link system, moveable segments are affected by points at which they are attached
lMovements at differing joints becomes predictable
•Based on model both closed and opened systems have been described relative to the body
 
Muscle Action in the Kinetic Chain
•Muscle actions that occur during open kinetic chain activities are often reversed during closed chain drills
lOpen chain – muscle origin is fixed with insertion moving
lClosed chain – muscle insertion segment is fixed and muscle work to move origin
 
Advantages and Disadvantages of Open vs. Closed Kinetic Chain Exercises
•Advantages to both forms of exercise
•Closed Chain Exercises
lIncrease joint compressive forces
lIncrease joint congruency and stability
lDecrease shear forces
lDecrease acceleration forces
lStimulation of proprioceptors
lEnhanced dynamic stability
lMay be safer and produce less threatening forces
lCo-activation and co-contraction
lFunctional and very sports specific
 
 
•Open Kinetic Chain Exercises
lIncreased acceleration forces
lDecreased resistance forces
lIncreased distraction and rotational forces
lIncreased deformation of joint and muscle mechanoreceptors
lConcentric acceleration and eccentric deceleration forces
lPromotes functional activity
lOften isolated to single joint motion
lStrengthening and testing
 
•Additional Comparisons
lPredictable patterns of motion may be limited with closed chain activity
lLimited due to pain, swelling, muscle weakness of decreased ROM
lMovement compensations
lProximal and distal joints may not always display existing deficit
lOpen chain exercises allow for specific joint assessment
lClosed chain activities rely on more complex series of muscle contractions (agonist vs. antagonist)
Using Closed Kinetic Chain Exercises to Regain Neuromuscular Control
•Functional weight-bearing activity requires coordinated muscle and joint function
•Lack of normal motion due to injury disrupts movement on multiple levels
•Closed chain activities requires integrated action of all segments – facilitates proprioception and joint position sense
•Open kinetic chain activities are used primarily to develop muscular strength
Biomechanics of Open vs. Closed Kinetic Chain Activities in the Lower Extremity
•Requirements for normal function
lSeries of well-timed muscle activation
lShock absorption
lFoot flexibility
lFoot stabilization
lAcceleration and deceleration
lMulti-planar motion
lJoint stabilization
The Knee Joint
•Shear force
lOccurs in posterior direction causes anterior displacement of tibia
•Compressive force
lDirected along long axis of tibia
•Closed chain position
lInduce hamstring contraction
lFlexion moment at knee and hip (hamstrings stabilize pelvis while quadriceps stabilize knee)
lHelps to minimize shear force on tibia
lEnhanced further with trunk anterior flexion (change in CoG due to shortened knee moment and shear)
lMinimize knee increase hip flexion moment
 
lFlexion moment at ankle is also created
lSoleus stabilizes ankle flexion and creates knee extension moment
lNeutralizes anterior shear force at knee
lEntire lower extremity kinetic chain is recruited via an axially directed force at the distal segment
•Open Kinetic Chain position (seated leg ext.)
lResistive force applied to distal tibia creating flexion moment at knee
lNegates hamstring co-contraction resulting in maximal shear forces
 
•Patellofemoral Joint
lWith OKC, flexion moment increases as knee moves from 90 degree flexion to extension
lResults in increased patellofemoral reaction force
lPatellofemoral contact area decreases closer to extension = increased contact stress
lDuring CKC, flexion moment increases as well
lPatella has larger contact surface with respect to femur
lContact stress is minimized
Closed Kinetic Chain Exercises for the Lower Extremity
•Better understanding of kinesiology and biomechanics has allowed for increased and earlier use in rehabilitation
 
•Alteration in rehabilitation techniques and shift in protocols
 
•Number of lower extremity exercises available
 
 
Mini-squat, Wall Slides and Lunges
•Mini-squat and Wall Slides
lConcurrent shift contraction
lSimultaneous hip and knee extension (0-40 degrees)
lAs hip extends quads contract eccentrically, hamstrings contract concentrically
lWith knees extending, hamstrings contracts eccentrically with quadriceps firing concentrically
 
lConcurrent shift minimize forces at knee
lIncreasing depth of squat results in increased moment at knee
lMoving feet forward increases activity of quadriceps and plantar flexors
•Lunges
lUtilized in later stages of rehabilitation
lEncourages quadriceps eccentric activity and co-contractions
 
Leg Press
•Decreases strain on low back, provides stability and takes advantage of kinetic chain
•Allows for
lTraining more or less than body weight
lTraining legs independently
•Recommendations
lTrain 0-60 degrees
lShould allow for maximum hip extension (supine)
lMaximizing concurrent shift and hamstring recruitment
lFoot plates should move in arc of motion and maximize knee extension (perpendicular to hip)
Stair Climbing
•Useful for cardiovascular fitness and as OKC unit
•Functions, biomechanicaly, similar to leg press
•Maintain erect body position to maximize hamstring recruitment
•Elicits increased quadriceps EMG compared to hamstrings
Step-Ups
•Can be performed forward, backward and laterally
•Lateral step-ups used primarily
•Height is adjustable
lHeight above 8 inches results in large flexion moment at knee, increasing shear forces and limiting hamstring co-contraction
•Elicit increased hamstring EMG compared to stair-climbing
 
•Encourages movement of full body weight
lStair climber maintains CoG at constant height
•Use caution when anterior shear forces are a concern
lLateral step-up results in high levels of shear
lHamstring activity not significant enough to neutralize forces
•Ideal for quadriceps strengthening
Terminal Knee Extensions with Surgical Tubing
•Means for safely developing quadriceps strength (0-30 degrees)
•Produces anterior shear force of femur, decreasing anterior translation of tibia
•Quadriceps are forced to contract eccentrically as knee moves into flexion
Stationary Bicycling
•Generally used for conditioning
•Amount of weight bearing force exerted can be adapted based on athlete’s limitations
•Seat height must be adjusted to minimize knee flexion moment
•Seat can also be adjusted for ROM activities
•Toe-clips facilitate hamstring activity
BAPS Board and Mini-tramp
•Unstable bases of support to facilitate proprioception and neuromuscular control
•BAPS Board
lProgressive and controlled stresses
lStrength, ROM, and neuromuscular control
•Mini-tramp
lSimilar goals as BAPS board
lCan also be utilized for more advanced plyometric training
Slide Boards and Fitter
•Provides more functional weight shifts
•Helps to re-establish dynamic control and cardiorespiratory fitness
•Produce valgus and varus stresses
Biomechanics of Open vs. Closed Kinetic Chain Activities in the Upper Extremity
•CKC exercise should also be incorporated into upper extremity rehabilitation
•Upper extremity generally operates as an open kinetic chain
lHigh velocity, dynamic movements
lProximal segments serve stabilization role while distal segments exhibit high degree of mobility
•Solely CKC activities
lPush-ups, chin-ups, handstands
•Combination activities
lSwimming and cross country skiing
 
•CKC generally used in upper extremity to strength and develop neuromuscular control in stabilizing musculature
lAllows them to function as a stable base more effectively during dynamic movements of distal segments
•Body works as dynamic unit, not isolated segments
lLess traditional approach – focus on segments
lIncorporate legs and core
Shoulder Complex Joint
•CKC exercises can promote and enhance joint stability
lRely on axial and rotational forces
lEnhances joint compression and approximation
lEnhancement of co-contractions
•Enhances force couples
lAnterior deltoid: teres minor and infraspinatus
lSubscapularis: infraspinatus and teres minor
•Function of scapula stabilizers
lLower trapezius: Upper trapezius and levator scapulae
lRhomboids and middle trapezius: Serratus anterior
Elbow
•Elbow is highly involved in open kinetic chain activities
lPropels objects at rapid velocities with accuracy
lWhen hitting, it must possess static stability and dynamic strength
lSwimming require it to produce power, and stability
lGymnastics and wrestling rely on it as both an open and closed kinetic link for both stability and propulsion
Closed Kinetic Chain Exercises for the Upper Extremity
•Used to train co-contractions in the shoulder early in the rehabilitation phase
lEnhance stability and decrease shutdown of rotator cuff secondary to pain
•Can be utilized in later stages for endurance of glenohumeral and scapulothoracic musculature
•OKC exercises should also be incorporated particularly during middle phase of shoulder rehabilitation
 
 
•For the elbow, CKC exercises assist in enhanced muscular balance and neuromuscular control of surrounding musculature
lImprove dynamic stability of proximal muscles
•OKC exercises are essential for regaining strength necessary for high velocity dynamic movements
lThrowing activities
 
Weight Shifting
•Variety of exercises available that facilitate dynamic stability through axial compression
•Can be performed in a series of positions on varying surfaces
•Degrees of body weight can also be altered
 
•Shifting can occur in multiple directions
•Alterations in base of support
•PNF patterns can be incorporated
•Rhythmic stabilization
Push-Ups, Push-Ups with a Plus, Pres-Ups and Step-ups
•Push-ups and press-ups used for neuromuscular control
lUse of physioball employs strengthening and stabilization of agonists and antagonists
lStair climber or lateral step up variations
lPush-up with plus facilitates serratus function necessary for scapular dynamics
lPress-ups involve isometric contraction of glenohumeral stabilizers
 
Push-Ups, Push-Ups with a Plus, Pres-Ups and Step-ups
Slide Board
•Promotes strength and stability as well as muscular endurance
•Reciprocating action
lForward, backward
lSide-to-side
lCircular patterns
lCan be performed in a standing position
Isokinetic Closed Kinetic Chain Exercise
•Biodex attachment allows for isokinetic conditioning and testing in closed kinetic chain position
•Data on reliability, validity and effectiveness are not available yet
 

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河北黄大仙 [2011-2-3]
 
蔡主任你好! 请问一个问题:比如双脚着地,一只脚没有完全把体重压过去,能算是闭合运动链吗?谢谢!
 
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