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髋部和足踝力学的临床测量作为后足运动和姿势的预测指标。

Clinical measures of hip and foot-ankle mechanics as predictors of rearfoot motion and posture.

作者信息

Souza Thales R, Mancini Marisa C, Araújo Vanessa L, Carvalhais Viviane O C, Ocarino Juliana M, Silva Paula L, Fonseca Sérgio T

机构信息

Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, CEP 31270-010 Belo Horizonte, MG, Brazil.

Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, CEP 31270-010 Belo Horizonte, MG, Brazil.

出版信息

Man Ther. 2014 Oct;19(5):379-85. doi: 10.1016/j.math.2013.10.003. Epub 2013 Oct 29.

Abstract

Health professionals are frequently interested in predicting rearfoot pronation during weight-bearing activities. Previous inconsistent results regarding the ability of clinical measures to predict rearfoot kinematics may have been influenced by the neglect of possible combined effects of alignment and mobility at the foot-ankle complex and by the disregard of possible influences of hip mobility on foot kinematics. The present study tested whether using a measure that combines frontal-plane bone alignment and mobility at the foot-ankle complex and a measure of hip internal rotation mobility predicts rearfoot kinematics, in walking and upright stance. Twenty-three healthy subjects underwent assessment of forefoot-shank angle (which combines varus bone alignments at the foot-ankle complex with inversion mobility at the midfoot joints), with a goniometer, and hip internal rotation mobility, with an inclinometer. Frontal-plane kinematics of the rearfoot was assessed with a three-dimensional system, during treadmill walking and upright stance. Multivariate linear regressions tested the predictive strength of these measures to inform about rearfoot kinematics. The measures significantly predicted (p ≤ 0.041) mean eversion-inversion position, during walking (r(2) = 0.40) and standing (r(2) = 0.31), and eversion peak in walking (r(2) = 0.27). Greater values of varus alignment at the foot-ankle complex combined with inversion mobility at the midfoot joints and greater hip internal rotation mobility are related to greater weight-bearing rearfoot eversion. Each measure (forefoot-shank angle and hip internal rotation mobility) alone and their combination partially predicted rearfoot kinematics. These measures may help detecting foot-ankle and hip mechanical variables possibly involved in an observed rearfoot motion or posture.

摘要

医疗保健专业人员常常对预测负重活动期间的后足内旋感兴趣。先前关于临床测量预测后足运动学能力的结果并不一致,这可能是由于忽视了足踝复合体对线和活动度可能的综合影响,以及忽视了髋关节活动度对足部运动学可能的影响。本研究测试了在步行和直立姿势下,使用一种结合了额状面骨对线和足踝复合体活动度的测量方法以及一种髋关节内旋活动度的测量方法是否能预测后足运动学。23名健康受试者接受了使用角度计对前足-小腿角度(其结合了足踝复合体的内翻骨对线和中足关节的内翻活动度)的评估,以及使用倾角仪对髋关节内旋活动度的评估。在跑步机行走和直立姿势期间,使用三维系统评估后足的额状面运动学。多元线性回归测试了这些测量方法对后足运动学的预测强度。这些测量方法在步行(r(2)=0.40)和站立(r(2)=0.31)期间显著预测了(p≤0.041)平均外翻-内翻位置,以及步行期间的外翻峰值(r(2)=0.27)。足踝复合体更大的内翻对线值与中足关节的内翻活动度以及更大的髋关节内旋活动度与更大的负重后足外翻有关。每种测量方法(前足-小腿角度和髋关节内旋活动度)单独以及它们的组合都部分预测了后足运动学。这些测量方法可能有助于检测可能与观察到的后足运动或姿势有关的足踝和髋关节力学变量。

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