Alimerzaloo Farnaz, Kashani Reza V, Saeedi Hassan, Farzi Marjan, Fallahian Nader
1Rehabilitation Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Prosthet Orthot Int. 2014 Feb;38(1):34-8. doi: 10.1177/0309364613486916. Epub 2013 May 20.
Heel clearance and ankle status (free or locked) are of major determinants affecting peak plantar pressures and contact area in patellar tendon bearing brace and have been separately studied by many researchers. This study investigated the combined effect of ankle status and heel clearance on contact area and peak plantar pressure in different areas of foot (hindfoot, midfoot, and forefoot).
Before-after repeated measurement trial.
Nine healthy male volunteers walked 8 m with normal shoe and four conditions of patellar tendon bearing brace wear. Repeated-measure analysis of variance test was used to compare contact area and plantar pressure changes in three areas of the foot.
Application of patellar tendon bearing brace significantly reduced overall plantar pressure and contact area (p < 0.01). Although both contact area and plantar pressure significantly decreased in hindfoot and midfoot, plantar pressure increased in forefoot area (p < 0.05).
Application of the patellar tendon bearing brace can reduce the overall peak plantar pressure in the foot but increases focal plantar pressure in forefoot. Excessive lifting of the heel seems to minimize the contact area, thus increase focal pressure in forefoot. Overall, plantar pressure seems to be more effectively off-loaded by combining maximum heel clearance and restriction of the ankle joint.
Although effective parameters of patellar tendon bearing brace have been separately addressed in previous studies, no study was found that investigated the combined effect of ankle status and heel clearance. This study investigates the combined effect of these parameters and provides detailed information on clinical application of the patellar tendon bearing brace.
足跟间隙和踝关节状态（自由或锁定）是影响髌腱承重支具足底峰值压力和接触面积的主要决定因素，许多研究人员已分别对其进行了研究。本研究调查了踝关节状态和足跟间隙对足部不同区域（后足、中足和前足）接触面积和足底峰值压力的联合影响。
前后重复测量试验。
9名健康男性志愿者穿着普通鞋子行走8米，并在佩戴髌腱承重支具的四种条件下行走。采用重复测量方差分析试验比较足部三个区域的接触面积和足底压力变化。
佩戴髌腱承重支具显著降低了整体足底压力和接触面积（p < 0.01）。尽管后足和中足的接触面积和足底压力均显著降低，但前足区域的足底压力增加（p < 0.05）。
佩戴髌腱承重支具可降低足部整体足底峰值压力，但会增加前足的局部足底压力。足跟过度抬起似乎会使接触面积最小化，从而增加前足的局部压力。总体而言，将最大足跟间隙与踝关节限制相结合似乎能更有效地减轻足底压力。
尽管先前的研究已分别探讨了髌腱承重支具的有效参数，但未发现有研究调查踝关节状态和足跟间隙的联合影响。本研究调查了这些参数的联合影响，并提供了有关髌腱承重支具临床应用的详细信息。
