Dicharry Jay M, Franz Jason R, Della Croce Ugo, Wilder Robert P, Riley Patrick O, Kerrigan D Casey
Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, VA 22903, USA.
J Orthop Sports Phys Ther. 2009 Aug;39(8):628-34. doi: 10.2519/jospt.2009.2968.
Controlled laboratory study using a cross-sectional design.
To compare the measurements of navicular drop during walking and running to those made clinically during a static position in a group of healthy young adults.
The navicular drop test is a common clinical measure of foot structure and, more specifically, of talonavicular joint function. Previous work has focused on static measurement to establish the relationship between navicular drop and various overuse injuries. However, loads on foot structure are dramatically increased during gait. Examining navicular drop dynamically is more reflective of the functional demands of the foot when walking and running.
The navicular drop of 72 healthy runners was evaluated using 2 static methods. Results were used to classify individuals into groups and compared to dynamic measures of navicular drop made during walking and running. Three-dimensional motion capture and an instrumented treadmill were used to assess dynamic navicular mobility. A repeated-measures analysis of variance (ANOVA) was performed to examine differences between measurement conditions. Between-group differences were assessed with independent-samples t test (P<.05).
Static measures of navicular drop were not found to be uniformly predictive of dynamic function during walking or running. Functional navicular drop measurements underestimated the dynamic measures in all foot types, while subtalar neutral drop overestimated dynamic measures for individuals with neutral and hypermobile foot types. No differences in navicular drop were found between foot types during walking, and small differences were found in running only between the hypomobile and hypermobile foot types. Maximum foot deformation during gait occurs at the time of maximum ground reaction force. Significant differences in navicular drop between foot type groups measured statically become muted when looking at group differences while walking and running.
Differences in navicular mobility between foot type groups during walking and running indicate that factors other than static alignment affect dynamic foot mobility. Dynamic assessment of navicular mobility may be an effective tool to examine the interplay of how the extrinsic force demands of gait and intrinsic structure and neuromuscular control affect foot function in walking and running.
采用横断面设计的对照实验室研究。
比较一组健康年轻成年人在行走和跑步过程中舟骨下降的测量值与临床静态位置测量值。
舟骨下降试验是一种常见的足部结构临床测量方法，更具体地说是距舟关节功能的测量方法。以往的研究主要集中在静态测量，以建立舟骨下降与各种过度使用损伤之间的关系。然而，在步态过程中，足部结构上的负荷会显著增加。动态检查舟骨下降更能反映行走和跑步时足部的功能需求。
使用两种静态方法评估72名健康跑步者的舟骨下降情况。结果用于将个体分组，并与行走和跑步过程中舟骨下降的动态测量值进行比较。使用三维运动捕捉和仪器化跑步机评估舟骨的动态活动度。进行重复测量方差分析（ANOVA）以检查测量条件之间的差异。组间差异采用独立样本t检验进行评估（P<0.05）。
未发现舟骨下降的静态测量值能一致地预测行走或跑步过程中的动态功能。功能性舟骨下降测量值在所有足型中均低估了动态测量值，而距下关节中立位下降则高估了中立型和高活动度足型个体的动态测量值。行走过程中不同足型之间舟骨下降无差异，跑步过程中仅在低活动度和高活动度足型之间发现微小差异。步态过程中最大足部变形发生在最大地面反作用力时。当观察行走和跑步时的组间差异时，静态测量的不同足型组之间舟骨下降的显著差异变得不明显。
行走和跑步过程中不同足型组之间舟骨活动度的差异表明，除了静态对线外，还有其他因素影响足部的动态活动度。舟骨活动度的动态评估可能是一种有效的工具，用于研究步态的外在力需求与内在结构和神经肌肉控制如何相互作用影响行走和跑步时的足部功能。
