Faculty of Sports Science, Ningbo University, Ningbo, China.
School of Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, Glasgow, UK.
J Anat. 2020 Sep;237(3):520-528. doi: 10.1111/joa.13207. Epub 2020 Jul 23.
Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p > .05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p < .001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p < .032) but no significant differences in the Y direction (p > .116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.
由于先前研究的数据存在冲突，因此开发了一种新的方法学方法来评估足跟垫的刚度和软组织变形。本研究的目的是比较男性和女性在动态卸载和加载活动中两条腿的足跟垫（HP）刚度。 10 名男性和 10 名女性自愿进行了三项动态试验，以卸载和加载 HP。动态方案由三个连续阶段组成：足底平（基线阶段），双侧脚跟抬高（卸载阶段）和足底平（加载阶段），每个阶段持续两秒钟。使用定制的标记集将六个反射标记（3mm）附着在左，右足跟的皮肤上。三维运动分析相机与力板同步，在整个试验过程中收集运动学和动力学数据。三向重复测量方差分析以及 Bonferroni 事后检验用于分析刚度和标记位移数据。平均而言，男性在加载和卸载阶段的 HP 刚度均高于女性。方差分析结果表明，在 X，Y 和 Z 方向上，性别，侧位或阶段相互作用对刚度和位移输出均无显着差异（p> 0.05）。无论方向如何，在基线和卸载条件之间的刚度均存在显着差异（p <0.001），但在基线和加载条件之间的刚度无显着差异（p = 1.000）。对于标记位移的事后分析，在 X 和 Z 方向上，各阶段之间的差异均具有统计学意义（p <0.032），但在 Y 方向上，差异无统计学意义（p> 0.116）。最后，女性的平均 HP 刚度水平较低，而男性的脚跟在 HP 卸载和加载时都更僵硬，尤其是在垂直方向（Z）。高 HP 刚度值和非常小的标记位移可能是病理性足部状况风险的有价值指标。
