Rouhani H, Crevoisier X, Favre J, Aminian K
Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Clin Biomech (Bristol). 2011 May;26(4):397-404. doi: 10.1016/j.clinbiomech.2010.11.011. Epub 2010 Dec 17.
This study aimed to use plantar pressure analysis in relatively long-distance walking for objective outcome evaluation of ankle osteoarthritis treatments, i.e., ankle arthrodesis and total ankle replacement.
Forty-seven subjects in four groups: three patient groups and controls, participated in the study. Each subject walked twice in 50-m trials. Plantar pressure under the pathological foot was measured using pressure insoles. Six parameters: initial contact time, terminal contact time, maximum force time, peak pressure time, maximum force and peak pressure were calculated and averaged over trials in ten regions of foot. The parameters in each region were compared between patient groups and controls and their effect size was estimated. Besides, the correlations between pressure parameters and clinical scales were calculated.
We observed based on temporal parameters that patients postpone the heel-off event, when high force in forefoot and high ankle moment happens. Also based on maximum force and peak pressure, the patients apply smoothened maximum forces on the affected foot. In ten regions, some parameters showed improvements after total ankle replacement, some showed alteration of foot function after ankle arthrodesis and some others showed still abnormality after both surgical treatments. These parameters showed also significant correlation with clinical scales in at least two regions of foot.
Plantar pressure parameters in relatively long-distance trials showed to be strong tools for outcome evaluation of ankle osteoarthritis treatments.
本研究旨在通过对较长距离行走时的足底压力分析,对踝关节骨关节炎的治疗方法,即踝关节融合术和全踝关节置换术进行客观疗效评估。
47名受试者分为四组:三个患者组和一个对照组,参与了本研究。每位受试者在50米的试验中行走两次。使用压力鞋垫测量患侧足部的足底压力。计算六个参数:初始接触时间、终末接触时间、最大力时间、峰值压力时间、最大力和峰值压力,并在足部的十个区域对试验结果求平均值。比较患者组和对照组在每个区域的参数,并估计其效应大小。此外,还计算了压力参数与临床量表之间的相关性。
基于时间参数,我们观察到,当出现前足高压力和高踝关节力矩时,患者会推迟足跟离地事件。同样基于最大力和峰值压力,患者在患侧足部施加平滑的最大力。在十个区域中,一些参数在全踝关节置换术后有所改善,一些参数在踝关节融合术后显示足部功能改变,还有一些参数在两种手术治疗后仍显示异常。这些参数在足部至少两个区域也与临床量表显著相关。
较长距离试验中的足底压力参数是评估踝关节骨关节炎治疗效果的有力工具。