Sport Sciences-Performance and Technology, Faculty of Medicine, Department of Health Science and Technology, Aalborg University, Aalborg East,Denmark.
Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring,Denmark.
J Appl Biomech. 2022 Jul 14;38(4):271-279. doi: 10.1123/jab.2022-0032. Print 2022 Aug 1.
Dysfunction of the tibialis posterior muscle is the most common cause of adult acquired flat foot. Tibialis posterior muscle weakness has been observed in several patient populations, including those in the early stages of rheumatoid arthritis. However, the influence of tibialis posterior weakness on gait mechanics is not fully understood, although gait instability has been reported. In 24 healthy participants, 3-dimension lower limb kinematics and kinetics during walking were evaluated bilaterally, before and after, a muscle fatigue protocol aiming to decrease the right foot adductor muscles strength, including the tibialis posterior muscle. The 3-dimension gait kinematics and kinetics were analyzed with statistical parametric mapping. The stance phase duration was increased for the right side. The right ankle external rotation moment decreased, and the left hip extension moment increased with reduced muscle strength compared with normal strength conditions. These changes are similar in patients with dysfunction in the tibialis posterior muscle, indicating that compensatory strategies observed in these patients might be related to the loss of tibialis posterior muscle strength. Such strategies may involve the unaffected side.
胫骨后肌功能障碍是成人获得性平足的最常见原因。胫骨后肌无力可见于多种患者群体,包括类风湿关节炎早期患者。然而,胫骨后肌无力对步态力学的影响尚不完全清楚,尽管已有报道称步态不稳定。在 24 名健康参与者中,我们在双侧分别评估了行走时的下肢 3 维运动学和动力学,在进行旨在降低右脚内收肌(包括胫骨后肌)力量的肌肉疲劳方案前后进行评估。使用统计参数映射分析 3 维步态运动学和动力学。与正常力量条件相比,右侧的支撑相持续时间增加。右侧踝关节外旋力矩减小,左侧髋关节伸展力矩增加,提示与正常力量条件相比,肌肉力量降低时会出现类似的变化。这些变化与胫骨后肌功能障碍患者的变化相似,表明这些患者观察到的代偿策略可能与胫骨后肌无力有关。这些策略可能涉及未受影响的一侧。