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慢性踝关节不稳患者足底压力的特征及相关因素

[Characteristics and related factors of plantar pressure in the chronic ankle instability individuals].

作者信息

Hou Z C, Ao Y F, Hu Y L, Jiao C, Guo Q W, Huang H S, Ren S, Zhang S, Xie X, Chen L X, Zhao F, Pi Y B, Li N, Jiang D

机构信息

Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.

Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Mar 26;53(2):279-285. doi: 10.19723/j.issn.1671-167X.2021.02.008.

Abstract

OBJECTIVE

To analyze characteristics and related factors of the plantar pressure during the level walking and single leg standing in the chronic ankle instability (CAI) individuals.

METHODS

From April 2019, 75 CAI individuals and 40 healthy individuals were enrolled in this study. Both of the static and dynamic plantar pressure were measured during six times level walking and three times single leg standing testing. The data including peak force, time to peak force in various foot contact areas and the time to boundary (TTB) and velocity of center of pressure (COP) were measured and compared between the affected side and the unaffected side and between the CAI cases and the healthy individuals. The correlations between the plantar pressure and the gender, Beighton score, affected side and body mass index (BMI) were analyzed.

RESULTS

The characteristics of plantar pressure distribution in the CAI individuals included: (1) During the level walking, the affected side showed the similar pressure contribution as the unaffected side (>0.05). While compared with healthy individuals, there was a significantly higher peak force in the 5th metatarsal area (=-3.86, =0.03) of the affected side, lower peak force in the 1st (=2.99, =0.02), 2nd metatarsal head areas (=2.09, =0.01) of the affected side, medial hindfoot areas of both sides (affected, =2.33, =0.01; unaffected, =3.74, =0.02) and toes areass of both sides (affected, =2.23, =0.01; unaffected, =3.28, =0.02) and a delay to peak force in the 4th metatarsal head area (=3.33, =0.01) of the affected side. (2) During the single leg standing, the CAI individuals showed significantly worse balance control in the anterior/posterior direction ( < 0.05) and lateral/medial direction ( < 0.05) compared with the healthy controls, and the affected side had more severe balance control deficit in the lateral/medial direction ( < 0.05). (3) The women ( < 0.05) and the individuals with higher Beighton scores ( < 0.05) showed worse balance control deficit in the lateral/medial direction.

CONCLUSION

CAI individuals showed significantly a more lateral shifted plantar distribution during the level walking compared with the healthy individuals and the tendency was worse on the affected sides, and showed worse balance control in the anterior/posterior direction and lateral/medial direction during the single leg standing. The women and those with generalized ligament laxity showed significantly worse balance control.

摘要

目的

分析慢性踝关节不稳(CAI)患者在平地行走和单腿站立时足底压力的特征及相关因素。

方法

从2019年4月起,本研究纳入了75例CAI患者和40例健康个体。在六次平地行走和三次单腿站立测试过程中,测量了静态和动态足底压力。测量并比较了患侧与健侧以及CAI患者与健康个体之间包括峰值力、各足部接触区域的峰值力时间、边界时间(TTB)和压力中心(COP)速度等数据。分析了足底压力与性别、Beighton评分、患侧和体重指数(BMI)之间的相关性。

结果

CAI患者足底压力分布特征包括:(1)在平地行走时,患侧与健侧的压力贡献相似(>0.05)。但与健康个体相比,患侧第5跖骨区域的峰值力显著更高(=-3.86,=0.03),患侧第1跖骨(=2.99,=0.02)、第2跖骨头区域(=2.09,=0.01)、双侧后足内侧区域(患侧,=2.33,=0.01;健侧,=3.74,=0.02)和双侧脚趾区域(患侧,=2.23,=0.01;健侧,=3.28,=0.02)的峰值力更低,且患侧第4跖骨头区域的峰值力延迟(=3.33,=0.01)。(2)在单腿站立时,与健康对照组相比,CAI患者在前后方向(<0.05)和内外方向(<0.05)的平衡控制明显更差,且患侧在内外方向的平衡控制缺陷更严重(<0.05)。(3)女性(<0.05)和Beighton评分较高的个体(<0.05)在内外方向的平衡控制缺陷更严重。

结论

与健康个体相比,CAI患者在平地行走时足底分布明显更偏向外侧移位,且患侧的这种倾向更明显,在单腿站立时,其在前后方向和内外方向的平衡控制更差。女性和存在全身性韧带松弛的个体的平衡控制明显更差。

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