Wibowo Dwi Basuki, Harahap Rudiansyah, Widodo Achmad, Haryadi Gunawan Dwi, Ariyanto Mochammad
Center for Biomechanics, Central Laboratory of Research and Services, Diponegoro University: Prof. Soedharto Street, Tembalang Semarang, Indonesia.
Orthopedic Section, RSUD Tugurejo Semarang, Indonesia.
J Phys Ther Sci. 2017 Dec;29(12):2068-2074. doi: 10.1589/jpts.29.2068. Epub 2017 Dec 7.
[Purpose] To investigate the effect of heel height on the distribution of plantar foot force and heel pain in patients with a heel spur. [Subjects and Methods] Plantar force was measured using 8 force sensors in 16 patients (3 men, 13 women), with symptomatic heel spur for 4 heel heights (0-4 cm). Sensors were located at the hallux (T1); medial to lateral metatarsals (M1 through M3), mid-foot (MF); and at the central, lateral, and medial heel (CH, LH, and MH). Pain was evaluated using the minimum compression force that caused pain and was measured using an algometer. [Results] Load bearing shifted from the heel (CH) to the mid-foot (MF) and hallux (T1) with increasing heel height. Raising the heel from 2 to 3 cm reduced the magnitude of load bearing, relative to the minimum compression force for pain, by 3.70% at the LH and 2.35% at the MH. Excellent clinical outcomes, defined by a 70-100% decrease in pain, were achieved in 10/16 participants with the use of a 2-cm and 3-cm heel height in men and women, respectively. [Conclusion] Increasing heel height effectively decreases the plantar force on the heel during weight-bearing activities.
[目的] 探讨鞋跟高度对跟骨骨刺患者足底压力分布及足跟疼痛的影响。[对象与方法] 使用8个力传感器对16例患者(3例男性,13例女性)的足底压力进行测量,这些患者患有有症状的跟骨骨刺,测量4种鞋跟高度(0 - 4厘米)下的足底压力。传感器分别位于拇趾(T1);第1至第3跖骨从内侧到外侧、足中部(MF);以及足跟中央、外侧和内侧(CH、LH和MH)。使用引起疼痛的最小压缩力评估疼痛,并使用痛觉计进行测量。[结果] 随着鞋跟高度增加,负重从足跟(CH)转移至足中部(MF)和拇趾(T1)。将鞋跟从2厘米提高到3厘米,相对于引起疼痛的最小压缩力,外侧足跟(LH)处的负重幅度降低了3.70%,内侧足跟(MH)处降低了2.35%。在男性和女性参与者中,分别使用2厘米和3厘米的鞋跟高度,10/16的参与者实现了70 - 100%的疼痛减轻,临床效果极佳。[结论] 增加鞋跟高度可有效降低负重活动期间足跟的足底压力。