跟垫升高对步态中跖屈肌和背屈肌活动的影响。

Effect of heel lifts on plantarflexor and dorsiflexor activity during gait.

机构信息

Department of Rehabilitation Medicine, Emory University School of Medicine, 1462 Clifton Road, Suite #312, Atlanta, GA 30307, USA.

出版信息

Foot Ankle Int. 2010 Nov;31(11):1014-20. doi: 10.3113/FAI.2010.1014.

DOI:10.3113/FAI.2010.1014

PMID:21189196

Abstract

BACKGROUND

Previous investigators have shown that high heels decrease the muscle activity of the gastrocnemius muscle during gait. However, it is not known whether commonly used in-shoe heel lifts of lower heights will demonstrate similar effects on muscle activity. The aim of this study was to determine whether heel lifts alter the muscle activity of the ankle plantarflexors and dorsiflexors during the stance phase of gait among individuals with limited gastrocnemius extensibility.

MATERIALS AND METHODS

This study used a repeated measures design. Twenty-four healthy volunteers (12 males and 12 females) with less than 5 degrees of passive ankle dorsiflexion with the knee extended participated in the study. Electromyography (EMG), computerized motion analysis, and a force plate were used to measure mean muscle activity of the lateral gastrocnemius, medial gastrocnemius, soleus and tibialis anterior muscles during the stance phase of gait across three walking conditions. Muscle activity was measured as participants ambulated at a self-selected speed in athletic shoes alone and with heel lifts of 6 mm and 9 mm inserted in athletic shoes.

RESULTS

Between heel-strike and heel-off, the mean EMG amplitude of the medial gastrocnemius increased with both 6 and 9 mm heel lifts and the amplitude of the tibialis anterior increased with 9 mm heel lifts compared to shoes alone. Between heel-strike and heel-off, there were no significant differences in mean EMG amplitude of the lateral gastrocnemius or soleus muscles walking in heel lifts compared to shoes alone. Between heel-off and toe-off, there were no significant differences in mean EMG amplitude of the lateral gastrocnemius, medial gastrocnemius, soleus, or tibialis anterior muscles when walking in heel lifts compared to shoes alone.

CONCLUSION

Heel lifts increase muscle activity of the medial gastrocnemius and tibialis anterior muscles between heel-strike and heel-off among individuals with limited gastrocnemius extensibility.

CLINICAL RELEVANCE

We were unable to confirm a decrease in muscle activity when using heel lifts.

摘要

背景

之前的研究人员已经表明，高跟鞋会降低步态中腓肠肌的肌肉活动。然而，目前尚不清楚较低高度的常用鞋内跟垫是否会对肌肉活动产生类似的影响。本研究的目的是确定跟垫是否会改变跟腱伸展度有限的个体在步态站立阶段时踝关节跖屈肌和背屈肌的肌肉活动。

材料和方法

本研究采用重复测量设计。24 名健康志愿者（12 名男性和 12 名女性）膝关节伸直时的被动踝关节背屈度小于 5 度，参与了本研究。肌电图（EMG）、计算机运动分析和力板用于测量三种步行条件下步态站立阶段时外侧腓肠肌、内侧腓肠肌、比目鱼肌和胫骨前肌的平均肌肉活动。在运动鞋中单独行走以及在运动鞋中插入 6 毫米和 9 毫米跟垫的情况下，测量参与者以自我选择的速度行走时的肌肉活动。

结果

在足跟触地和足跟离地之间，6 毫米和 9 毫米跟垫均使内侧腓肠肌的平均 EMG 振幅增加，而胫骨前肌的振幅则随 9 毫米跟垫增加。在足跟触地和足跟离地之间，与单独穿运动鞋相比，穿跟垫行走时外侧腓肠肌或比目鱼肌的平均 EMG 振幅没有显著差异。在足跟离地和足趾离地之间，与单独穿运动鞋相比，穿跟垫行走时外侧腓肠肌、内侧腓肠肌、比目鱼肌和胫骨前肌的平均 EMG 振幅没有显著差异。