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跟骨内翻、扁平足和高弓足的足踝运动学的节段性差异。

Segmental foot and ankle kinematic differences between rectus, planus, and cavus foot types.

机构信息

Marquette University, P.O. Box 1881, Milwaukee, WI 53201, USA; Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA.

Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA.

出版信息

J Biomech. 2019 Sep 20;94:180-186. doi: 10.1016/j.jbiomech.2019.07.032. Epub 2019 Aug 6.

Abstract

The presence of multiple foot types has been used to explain the variability of foot structure observed among healthy adults. These foot types were determined by specific static morphologic features and included rectus (well aligned hindfoot/forefoot), planus (low arched), and cavus (high arched) foot types. Unique biomechanical characteristics of these foot types have been identified but reported differences in segmental foot kinematics among them has been inconsistent due to differences in neutral referencing and evaluation of only select discrete variables. This study used the radiographically-indexed Milwaukee Foot Model to evaluate differences in segmental foot kinematics among healthy adults with rectus, planus, and cavus feet based on the true bony alignment between segments. Based on the definitions of the individual foot types and due to conflicting results in previous literature, the primary study outcome was peak coronal hindfoot position during stance phase. Additionally, locally weighted regression smoothing with alpha-adjusted serial t-test analysis (LAAST) was used to compare these foot types across the entire gait cycle. Average peak hindfoot inversion was -1.6° ± 5.1°, 6.7° ± 3.5°, and 13.6° ± 4.6°, for the Planus, Rectus, and Cavus Groups, respectively. There were significant differences among all comparisons. Differences were observed between the Rectus and Planus Groups and Cavus and Planus Groups throughout the gait cycle. Additionally, the Planus Group had a premature peak velocity toward coronal varus and early transition toward valgus, likely due to a deficient windlass mechanism. This assessment of kinematic data across the gait cycle can help understand differences in dynamic foot function among foot types.

摘要

多种足型的存在被用来解释健康成年人中观察到的足部结构的可变性。这些足型是通过特定的静态形态特征来确定的,包括直型(后足/前足排列良好)、平型(低足弓)和高弓型(高足弓)足型。这些足型具有独特的生物力学特征,但由于中立参考和仅选择离散变量的评估存在差异,报道的它们之间的节段性足部运动学差异并不一致。本研究使用放射学索引的密尔沃基足部模型,根据节段之间的真实骨骼对线,评估直型、平型和高弓型健康成年人的节段性足部运动学差异。基于个体足型的定义,并且由于之前文献中的结果相互矛盾,主要研究结果是站立相时的冠状位后足峰值位置。此外,还使用带有 alpha 调整的序列 t 检验分析的局部加权回归平滑(LAAST)比较了整个步态周期中的这些足型。平足、直足和高弓足组的平均峰值后足内翻分别为-1.6°±5.1°、6.7°±3.5°和 13.6°±4.6°。所有比较之间均存在显著差异。在整个步态周期中,直足组和平足组以及高弓足组和平足组之间均存在差异。此外,平足组的冠状位内翻峰值速度过早,向冠状位旋前和向外侧过渡较早,可能是由于提踵机制不足。对步态周期中运动学数据的这种评估可以帮助理解不同足型之间动态足部功能的差异。

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