La Trobe University, Bundoora, Victoria 3086, Australia.
J Orthop Res. 2013 Mar;31(3):427-33. doi: 10.1002/jor.22229. Epub 2012 Sep 14.
Forefoot pain is a common problem in older people. We determined whether plantar pressures during gait and the relative lengths of the lesser metatarsals differ between older people with and without plantar forefoot pain. Dynamic plantar pressure assessment during walking was undertaken using the Tekscan MatScan® system in 118 community-dwelling older people (44 males and 74 females), mean age 74 (standard deviation=5.9) years, 43 (36%) of whom reported current or previous plantar forefoot pain. The relative lengths of metatarsals 1-5 were determined from weightbearing X-rays. Participants with current or previous plantar forefoot pain exhibited significantly (p=0.032) greater peak plantar pressure under metatarsal heads 3-5 (1.93 ± 0.41 kg/cm(2) vs. 1.74 ± 0.48 kg/cm(2) ). However, no differences were found in relative metatarsal lengths between the groups. These findings indicate that older people with forefoot pain generate higher peak plantar pressures under the lateral metatarsal heads when walking, but do not exhibit relatively longer lesser metatarsals. Other factors may be responsible for the observed pressure increase, such as reduced range of motion of the metatarsophalangeal joints and increased stiffness of plantar soft tissues.
足底前疼痛是老年人常见的问题。我们旨在确定行走时足底压力和第五跖骨相对长度是否存在差异。采用 Tekscan MatScan®系统对 118 名社区居住的老年人（男性 44 名，女性 74 名）进行动态足底压力评估，平均年龄 74 岁（标准差=5.9），其中 43 名（36%）报告存在当前或既往足底前疼痛。采用负重 X 线片确定跖骨 1-5 的相对长度。当前或既往足底前疼痛的参与者在跖骨头 3-5 处的峰值足底压力显著升高（p=0.032）（1.93 ± 0.41 kg/cm(2) vs. 1.74 ± 0.48 kg/cm(2)）。然而，两组之间的跖骨相对长度没有差异。这些发现表明，有足底前疼痛的老年人在行走时，外侧跖骨头下产生的峰值足底压力更高，但第五跖骨相对长度并没有延长。其他因素可能导致观察到的压力增加，例如跖趾关节活动范围减小和足底软组织僵硬。
