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步幅角和外侧楔形鞋垫对降低膝关节内收力矩的影响。

Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment.

作者信息

Tokunaga Ken, Nakai Yuki, Matsumoto Ryo, Kiyama Ryoji, Kawada Masayuki, Ohwatashi Akihiko, Fukudome Kiyohiro, Ohshige Tadasu, Maeda Tetsuo

机构信息

1 Kagoshima Seikyo Hospital.

2 Yasumatsu Orthopaedic Clinic.

出版信息

J Appl Biomech. 2016 Oct;32(5):454-61. doi: 10.1123/jab.2015-0163. Epub 2016 Aug 19.

Abstract

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.

摘要

本研究评估了步行过程中足前进角度对外侧楔形鞋垫减少膝关节内收力矩的影响。20名健康的年轻志愿者在三种足前进角度条件下,即自然、外八字和内八字,以舒适的速度穿着外侧楔形鞋垫或对照平底鞋垫行走10米。使用三维刚体链接模型计算膝关节外展力矩、地面反作用力至膝关节中心的力臂,以及膝关节内收力矩和力臂的减少率。结果表明,外八字条件和外侧楔形鞋垫在整个站立阶段均降低了膝关节内收力矩。膝关节内收力矩和力臂的减少率呈现密切关系。外侧楔形鞋垫由于地面反作用力力臂的减小,在各种足前进角度条件下均降低了膝关节内收力矩。此外,由于外侧楔形鞋垫和足前进角度的协同作用,穿着外侧楔形鞋垫的外八字步态期间膝关节内收力矩最小。无论足前进角度如何,外侧楔形鞋垫可能是膝关节骨关节炎患者的一种有效干预措施。

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