Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, St. Louis, MO, USA.
North Carolina State University, Department of Biomedical Engineering, 21 Current Dr, Raleigh, NC, USA.
Gait Posture. 2019 May;70:59-64. doi: 10.1016/j.gaitpost.2019.02.027. Epub 2019 Feb 25.
Orthopaedic boots with wedging are commonly used in the treatment of individuals with Achilles tendon rupture to immobilize the foot in plantar flexion and approximate tendon ends.
To describe changes in muscle activity of the triceps surae and gait mechanics with the use of wedges in an orthopaedic boot immediately and after an accommodation period.
Muscle activity of the triceps surae and gait parameters (vertical ground reaction force, knee extension power, gait speed) were collected using surface electromyography and motion capture in 12 healthy individuals. Participants walked in an instrumented orthopaedic boot with 0, 3, and 5 wedges tested in random order. Participants were provided a one hour accommodation period where time spent walking was collected. This was followed by a repeat assessment of triceps surae activity and gait.
Peak and integrated EMG in the medial gastrocnemius (p = 0.001, p < 0.001) and soleus (p = 0.010, p < 0.001) significantly decreased with increasing number of wedges. Peak and integrated EMG had a slight but non-significant decrease with increasing number of wedges in the lateral gastrocnemius (p = 0.151, p = 0.077). Vertical ground reaction force decreased (p = 0.019) and peak knee extension power increased (p = 0.003) with increasing number of wedges. There were no statistically significant differences in gait speed with wedges (p = 0.450). There were no significant changes in EMG or gait parameters from pre- to post-accommodation period.
A combination of factors yield decreased triceps surae activity in individuals wearing an orthopaedic boot with wedges - decreasing loading on the immobilized limb and shifting power generation proximally.
带有楔形物的矫形靴常用于治疗跟腱断裂的患者，以将足部固定在跖屈位并使跟腱末端靠近。
描述使用矫形靴中的楔形物时，跟腱断裂患者的小腿三头肌活动和步态力学的即刻和适应期变化。
12 名健康个体使用表面肌电图和运动捕捉收集小腿三头肌的肌肉活动和步态参数（垂直地面反作用力、膝关节伸展力、步速）。参与者以随机顺序分别穿着带有 0、3 和 5 个楔形物的仪器化矫形靴行走。为参与者提供一个小时的适应期，在此期间收集行走时间。然后重复评估小腿三头肌活动和步态。
内侧腓肠肌（p=0.001，p<0.001）和比目鱼肌（p=0.010，p<0.001）的肌电峰值和积分随着楔形物数量的增加而显著降低。外侧腓肠肌的肌电峰值和积分随着楔形物数量的增加略有但无统计学意义的降低（p=0.151，p=0.077）。随着楔形物数量的增加，垂直地面反作用力降低（p=0.019），膝关节伸展力峰值增加（p=0.003）。步速与楔形物无统计学差异（p=0.450）。适应期前后肌电或步态参数无显著变化。
多种因素导致穿着带有楔形物的矫形靴的个体小腿三头肌活动减少——减少对固定肢体的负荷并使力量产生向近端转移。
