Wang Chen, Geng Xiang, Wang Shaobai, Ma Xin, Wang Xu, Huang Jiazhang, Zhang Chao, Chen Li, Yang Junsheng, Li Jiabei, Wang Kan
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Harvard Medical School, Boston, MA, USA; Key Laboratory of Exercise and Health Science, Ministry of Education, Shanghai University of Sport, Shanghai, China.
J Electromyogr Kinesiol. 2016 Jun;28:7-16. doi: 10.1016/j.jelekin.2016.01.005. Epub 2016 Feb 17.
To explore the accurate in vivo kinematic changes in the ankle complex when wearing low- and high-heel shoes (LHS and HHS, respectively).
Twelve young women were tested unilaterally. Three-dimensional models of the tibia, talus, and calcaneus were first created based on CT scan results. The subjects walked at a self-controlled speed in barefoot, LHS (4cm), and HHS (10cm) conditions. A fluoroscopy system captured the lateral fluoroscopic images of the ankle complex. The images of seven key positions in the stance phase were selected, and 3D to 2D bone model registrations were performed to determine the joint positions. The mean of 6 degree of freedom (DOF) range of motions (ROM), joint positions, and angular displacements of the ankle complex during the gait were then obtained.
For the talocrural joint, the rotational ROMs of the subjects either in LHS or HHS condition displayed no significant difference from those in barefoot condition. For the subtalar joint, all the rotational ROMs in the HHS condition and the internal/external rotations in the LHS condition significantly decreased compared with those in the barefoot condition. The talocrural joint was positioned significantly more plantarflexed, inverted, internally rotated, and posteriorly seated in all seven poses in HHS condition, compared with those in barefoot condition.
HHS mainly affected the rotational motion of the ankle complex during walking. The talocrural joint position was abnormal, and the subtalar joint ROM decreased during the gait in HHS condition. Only a few kinematic changes occurred in LHS condition relative to the barefoot condition.
探讨穿着低跟鞋和高跟鞋（分别为LHS和HHS）时踝关节复合体在体内的准确运动学变化。
对12名年轻女性进行单侧测试。首先根据CT扫描结果创建胫骨、距骨和跟骨的三维模型。受试者在赤脚、LHS（4厘米）和HHS（10厘米）条件下以自我控制的速度行走。荧光透视系统采集踝关节复合体的侧位荧光透视图像。选择站立相七个关键位置的图像，进行三维到二维骨模型配准以确定关节位置。然后获得步态期间踝关节复合体的6个自由度（DOF）运动范围（ROM）、关节位置和角位移的平均值。
对于胫距关节，受试者在LHS或HHS条件下的旋转ROM与赤脚条件下相比无显著差异。对于距下关节，与赤脚条件相比，HHS条件下所有旋转ROM以及LHS条件下的内/外旋转均显著降低。与赤脚条件相比，在HHS条件下的所有七个姿势中，胫距关节的位置明显更跖屈、内翻、内旋和后移。
HHS主要影响步行过程中踝关节复合体的旋转运动。在HHS条件下，步态期间胫距关节位置异常，距下关节ROM降低。相对于赤脚条件，LHS条件下仅发生了一些运动学变化。
