1Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, BELGIUM; 2Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, England, UNITED KINGDOM; and 3Department of Bioengineering, Shinshu University, Ueda, JAPAN.
Med Sci Sports Exerc. 2013 Nov;45(11):2129-36. doi: 10.1249/MSS.0b013e31829991a2.
Many patients who sustain an acute lateral ankle sprain develop chronic ankle instability (CAI). Altered ankle kinematics have been reported to play a role in the underlying mechanisms of CAI. In previous studies, however, the foot was modeled as one rigid segment, ignoring the complexity of the ankle and foot anatomy and kinematics. The purpose of this study was to evaluate stance phase kinematics of subjects with CAI, copers, and controls during walking and running using both a rigid and a multisegmented foot model.
Foot and ankle kinematics of 77 subjects (29 subjects with self-reported CAI, 24 copers, and 24 controls) were measured during barefoot walking and running using a rigid foot model and a six-segment Ghent Foot Model. Data were collected on a 20-m-long instrumented runway embedded with a force plate and a six-camera optoelectronic system. Groups were compared using statistical parametric mapping.
Both the CAI and the coper group showed similar differences during midstance and late stance compared with the control group (P < 0.05). The rigid foot segment showed a more everted position during walking compared with the control group. Based on the Ghent Foot Model, the rear foot also showed a more everted position during running. The medial forefoot showed a more inverted position for both running and walking compared with the control group.
Our study revealed significant midstance and late stance differences in rigid foot, rear foot, and medial forefoot kinematics The multisegmented foot model demonstrated intricate behavior of the foot that is not detectable with rigid foot modeling. Further research using these models is necessary to expand knowledge of foot kinematics in subjects with CAI.
许多急性外踝扭伤患者会发展为慢性踝关节不稳定（CAI）。已有研究报道踝关节运动学改变在 CAI 的潜在发病机制中起作用。然而，在以前的研究中，脚被建模为一个刚性部分，忽略了脚踝和脚部解剖结构和运动学的复杂性。本研究旨在使用刚性和多节段脚模型评估 CAI、代偿者和对照组在步行和跑步时的站立相运动学。
使用刚性脚模型和六节段根特脚模型测量了 77 名受试者（29 名自报告 CAI、24 名代偿者和 24 名对照组）在赤脚行走和跑步时的足和踝关节运动学。数据是在一个 20 米长的仪器跑道上收集的，该跑道嵌入了一个力板和一个六相机光电系统。使用统计参数映射比较组间差异。
CAI 组和代偿者组在中足和后足期与对照组相比表现出相似的差异（P < 0.05）。与对照组相比，刚性脚段在行走时表现出更外翻的位置。基于根特脚模型，后脚在跑步时也表现出更外翻的位置。与对照组相比，前足内侧在跑步和步行时都表现出更内翻的位置。
本研究揭示了刚性脚、后脚和前足内侧运动学在中足和后足期的显著差异。多节段脚模型展示了脚的复杂行为，这是刚性脚建模无法检测到的。需要进一步使用这些模型进行研究，以扩展对 CAI 患者脚部运动学的认识。
