Button Keith D, Braman Jerrod E, Davison Mark A, Wei Feng, Schaeffer Maureen C, Haut Roger C
J Biomech Eng. 2015 Jun;137(6):061004. doi: 10.1115/1.4029979. Epub 2015 Mar 23.
While previous studies have investigated the effect of shoe-surface interaction on injury risk, few studies have examined the effect of rotational stiffness of the shoe. The hypothesis of the current study was that ankles externally rotated to failure in shoes with low rotational stiffness would allow more talus eversion than those in shoes with a higher rotational stiffness, resulting in less severe injury. Twelve (six pairs) cadaver lower extremities were externally rotated to gross failure while positioned in 20 deg of pre-eversion and 20 deg of predorsiflexion by fixing the distal end of the foot, axially loading the proximal tibia, and internally rotating the tibia. One ankle in each pair was constrained by an American football shoe with a stiff upper, while the other was constrained by an American football shoe with a flexible upper. Experimental bone motions were input into specimen-specific computational models to examine levels of ligament elongation to help understand mechanisms of ankle joint failure. Ankles in flexible shoes allowed 6.7±2.4 deg of talus eversion during rotation, significantly greater than the 1.7±1.0 deg for ankles in stiff shoes (p = 0.01). The significantly greater eversion in flexible shoes was potentially due to a more natural response of the ankle during rotation, possibly affecting the injuries that were produced. All ankles failed by either medial ankle injury or syndesmotic injury, or a combination of both. Complex (more than one ligament or bone) injuries were noted in 4 of 6 ankles in stiff shoes and 1 of 6 ankles in flexible shoes. Ligament elongations from the computational model validated the experimental injury data. The current study suggested flexibility (or rotational stiffness) of the shoe may play an important role in both the severity of ankle injuries for athletes.
虽然先前的研究调查了鞋与地面相互作用对受伤风险的影响，但很少有研究考察鞋的旋转刚度的影响。本研究的假设是，与旋转刚度较高的鞋相比，在旋转刚度较低的鞋中，踝关节外旋至失效时会允许距骨有更多的外翻，从而导致损伤较轻。通过固定足部远端、对近端胫骨进行轴向加载以及使胫骨内旋，将12条（6对）尸体下肢置于20°的预外翻和20°的背屈前位，然后外旋至完全失效。每对中的一个踝关节由鞋面较硬的美式足球鞋约束，而另一个则由鞋面较灵活的美式足球鞋约束。将实验性的骨骼运动输入特定于标本的计算模型，以检查韧带伸长水平，从而有助于理解踝关节失效的机制。在旋转过程中，穿灵活鞋子的踝关节允许距骨外翻6.7±2.4°，显著大于穿硬鞋子的踝关节的1.7±1.0°（p = 0.01）。灵活鞋子中外翻明显更大可能是由于旋转过程中踝关节更自然的反应，这可能会影响所产生的损伤。所有踝关节均因内踝损伤或下胫腓联合损伤或两者的组合而失效。在硬鞋子的6个踝关节中有4个以及灵活鞋子的6个踝关节中有1个出现了复杂（不止一条韧带或骨骼）损伤。计算模型中的韧带伸长验证了实验性损伤数据。本研究表明，鞋子的柔韧性（或旋转刚度）可能在运动员踝关节损伤的严重程度方面都起着重要作用。
