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慢性踝关节不稳患者跑步时的足底压力。

Plantar pressure during running in subjects with chronic ankle instability.

机构信息

West Chester University, Sports Medicine, 313 Sturzebecker Building, West Chester University, West Chester, PA 19382, USA.

出版信息

Foot Ankle Int. 2010 Nov;31(11):994-1000. doi: 10.3113/FAI.2010.0994.

Abstract

BACKGROUND

It has been suggested that dynamic foot and ankle mechanics predispose individuals with CAI to repetitive episodes of the ankle ``giving way.'' Plantar pressure variations during a walking gait have been detected in those with CAI, but more dynamic conditions for analysis are needed. The purpose of this study was to evaluate plantar pressure distributions during a running gait in individuals with CAI, individuals who suffered a lateral ankle sprain, but did not develop CAI (AS), and subjects with no history of a lateral ankle sprain (CON).

MATERIALS AND METHODS

Forty-five subjects [15 in each group, healthy males (18) and females (27), age 18 to 45] were recruited from University communities to participate in this study. Plantar pressure distributions were analyzed on a Tekscan© plantar pressure mat at 66 frames per second during a running gait at a controlled speed. The following variables were obtained: rearfoot medial/lateral (M/L) pressure ratio at foot strike (FS) and center-of-pressure (COP) trajectory during the initial loading response (heel strike to initial peak GRF). Separate one-way ANOVA with Tukey's post-hoc were used to test for group differences. The significance level was defined as p < 0.05.

RESULTS

The CAI group had a significantly more lateral ratio (0.97 ± 0.12) at FS when compared to the CON (1.01 ± 0.13) and AS (1.11 ± 0.13) groups. The CAI subjects had a lateral COP trajectory during the loading phase (7.97 degrees ± 11.02), while both the AS (-3.68 degrees ± 10.24) and CON groups (-6.27 degrees ± 9.86) had medial trajectories. The difference was significant between the CAI group and both the AS and CON groups (all significant {\it p} values were less than 0.05).

CONCLUSION

Our results confirm that CAI subjects have a more lateral foot positioning and loading pattern during a barefoot running gait when compared to both the CON and LAS groups.

CLINICAL RELEVANCE

Clinicians treating patients with CAI should consider providing interventions to decrease the amount of rearfoot inversion at FS and during loading in order to create a more medial COP trajectory upon impact.

摘要

背景

有人认为,动态的足部和踝关节力学使 CAI 患者容易反复出现踝关节“发软”。在 CAI 患者的行走步态中已经检测到足底压力的变化,但需要更动态的分析条件。本研究的目的是评估 CAI 患者、未发生 CAI(AS)的外侧踝关节扭伤患者和无外侧踝关节扭伤史的受试者(CON)在跑步步态中的足底压力分布。

材料和方法

从大学社区招募了 45 名受试者(每组 15 名,健康男性 18 名,女性 27 名,年龄 18 至 45 岁)参与本研究。在受控速度下,使用 Tekscan©足底压力垫以 66 帧/秒的速度分析跑步步态时的足底压力分布。获得以下变量:在初始负重反应期间(足跟接触到初始最大 GRF)足部着地时的后足内侧/外侧(M/L)压力比(FS)和中心压力轨迹(COP)。采用单因素方差分析和 Tukey 事后检验进行组间差异检验。显著性水平定义为 p<0.05。

结果

与 CON(1.01±0.13)和 AS(1.11±0.13)组相比,CAI 组在 FS 时的外侧比值(0.97±0.12)明显更高。CAI 患者在负重阶段有一个外侧 COP 轨迹(7.97 度±11.02),而 AS(-3.68 度±10.24)和 CON 组(-6.27 度±9.86)均有内侧轨迹。CAI 组与 AS 和 CON 组之间的差异均有统计学意义(所有有统计学意义的{\it p}值均小于 0.05)。

结论

我们的结果证实,与 CON 和 LAS 组相比,CAI 患者在赤脚跑步步态中足部位置和负重模式更偏向外侧。

临床相关性

治疗 CAI 患者的临床医生应考虑提供干预措施,以减少 FS 和负重期间的后足内翻量,以便在撞击时形成更内侧的 COP 轨迹。

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