Xu H, Akai M, Kakurai S, Yokota K, Kaneko H
Department of Rehabilitation Medicine, Faculty of Medicine, the University of Tokyo, Japan.
Am J Phys Med Rehabil. 1999 Nov-Dec;78(6):516-24. doi: 10.1097/00002060-199911000-00005.
This study was conducted to determine the effect of footwear modification on patients with neuromusculoskeletal disorders. Two analyses, the center of pressure and the in-shoe plantar pressures, were studied with the help of healthy volunteers so that the effect of shoe modifications could be assessed. The ground force under the sole of the shoe was measured while the subjects were walking, and the plantar pressure at the foot-insole interface and its distribution were measured while the subjects were in both the standing and walking positions, wearing the trial shoes. The trial shoes had three different types of heels-standard heel, Thomas heel, and reverse Thomas heel-and had three different locations for the rocker bar--just under the metatarsophalangeal joint, 1 cm behind the metatarsophalangeal joint, and 1 cm before the metatarsophalangeal joint. The shift change at the center of pressure showed that the Thomas heel generally pushed the center of pressure more laterally and the reverse Thomas heel shifted it medially more than the standard heel did. While the subjects were in a stable standing position wearing the Thomas heel shoes, the medial forefoot and the lateral heel region's pressure showed significant reduction in the plantar pressure and the lateral forefoot and the medial heel showed a tendency to rise, compared with the standard heel condition. When the trial shoes' heels were changed to the reverse Thomas heel, the above changes tended to reverse. Tests at the foot-insole interface showed that the different types of heels and the location of the bar could change not only the pressure distribution but also the duration of the plantar pressure under the lateral area that shifted to the medial area when the subjects walked. This pressure measurement method was very useful for the design and evaluation of such footwear.
本研究旨在确定鞋类改良对神经肌肉骨骼疾病患者的影响。借助健康志愿者对压力中心和鞋内足底压力这两项分析进行了研究，以便评估鞋类改良的效果。在受试者行走时测量鞋底下方的地面力，在受试者穿着试验鞋处于站立和行走姿势时，测量鞋垫界面处的足底压力及其分布。试验鞋有三种不同类型的鞋跟——标准鞋跟、托马斯鞋跟和反向托马斯鞋跟——并且摇杆有三个不同的位置——恰好在跖趾关节下方、跖趾关节后方1厘米处以及跖趾关节前方1厘米处。压力中心的变化表明，与标准鞋跟相比，托马斯鞋跟通常会将压力中心向外侧推动得更多，而反向托马斯鞋跟会将其向内侧移动得更多。当受试者穿着托马斯鞋跟的鞋子处于稳定站立姿势时，与标准鞋跟情况相比，前足内侧和足跟外侧区域的足底压力显著降低，而前足外侧和足跟内侧则有上升趋势。当试验鞋的鞋跟换成反向托马斯鞋跟时，上述变化往往会逆转。在鞋垫界面处的测试表明，不同类型的鞋跟和摇杆的位置不仅会改变压力分布，还会改变受试者行走时从外侧区域转移到内侧区域的足底压力持续时间。这种压力测量方法对于此类鞋类的设计和评估非常有用。
