健康老年人足踝关节灵活性测量值与赤脚足底压力的关系：一项横断面研究。
The relationship between foot and ankle joint flexibility measures and barefoot plantar pressures in healthy older adults: a cross-sectional study.
机构信息
School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Central Coast Campus, 10 Chittaway Road, Ourimbah, Callaghan, NSW, 2258, Australia.
Discipline of Podiatry, School of Health Science, Western Sydney University, Campbelltown, NSW, Australia.
出版信息
BMC Musculoskelet Disord. 2022 Jul 30;23(1):729. doi: 10.1186/s12891-022-05618-w.
BACKGROUND
Restriction in foot and ankle joint range of motion, such as an ankle equinus, has been associated with increased plantar pressure and its complications. However, previous research is limited by its scope of measures and study populations. The aim of this study was to investigate the relationship between foot and ankle joint range of motion on barefoot plantar pressures during walking in healthy older adults.
METHODS
This cross-sectional study recruited 49 older adults. Participants underwent measures of foot (first metatarsophalangeal dorsiflexion range of motion, and navicular drop and drift) and ankle joint range of motion, foot posture, body mass index, and plantar pressure during barefoot walking. Spearman Rank Order Correlations were used to explore the relationship between foot and ankle measures, body mass index, and plantar pressure, with significant correlations explored in a hierarchical regression analysis. A Mann-Whitney U test was performed to compare plantar pressure values between those with and without ankle equinus per region of the foot.
RESULTS
Mean (SD) age and BMI were 72.4 years (5.2) and 29.8 kg/m (5.9) respectively. A total of 32 of the 49 participants (65%) identified as female sex. Mean (SD) ankle joint range of motion was 32.7 (6.4) degrees with 17/49 (34.7%) participants classified as having an ankle equinus (defined as < 30 degrees of ankle joint dorsiflexion range of motion). We found that an ankle equinus predicted a statistically significant amount of peak forefoot plantar pressure (p = 0.03). Participants with an ankle equinus displayed significantly higher forefoot peak pressure 677.8 kPa (589.9 to 810.4) compared to those with no equinus 565.58 kPa (447.3 to 651.2), p = 0.02. A statistically significant correlation was found between body mass index and midfoot peak pressure (p < 0.01) and pressure-time integral (p < 0.01). No other significant correlations were found.
CONCLUSION
Clinicians should consider screening for an ankle equinus and body mass index as a simple way to identify which healthy older adults may be at risk of pressure-related complications in the mid- and forefoot.
背景
踝关节和足部关节活动范围受限，如足下垂，与足底压力增加及其并发症有关。然而，以前的研究受到其测量范围和研究人群的限制。本研究旨在探讨健康老年人在赤脚行走时足部和踝关节活动范围与足底压力之间的关系。
方法
这项横断面研究招募了 49 名老年人。参与者接受了足部（第一跖趾关节背屈活动范围、舟骨下降和漂移）和踝关节活动范围、足弓、体重指数和赤脚行走时足底压力的测量。采用 Spearman 秩相关分析探讨足部和踝关节测量值、体重指数与足底压力之间的关系，并在分层回归分析中探讨显著相关关系。采用 Mann-Whitney U 检验比较足部各区域有无足下垂的足底压力值。
结果
平均（标准差）年龄和 BMI 分别为 72.4 岁（5.2）和 29.8kg/m2（5.9）。49 名参与者中有 32 名（65%）为女性。踝关节活动范围的平均值（标准差）为 32.7（6.4）度，其中 17/49（34.7%）参与者被归类为患有足下垂（定义为踝关节背屈活动范围小于 30 度）。我们发现，足下垂可显著预测前足峰值足底压力（p=0.03）。足下垂患者的前足峰值压力为 677.8kPa（589.9 至 810.4），显著高于无足下垂患者的 565.58kPa（447.3 至 651.2），p=0.02。体重指数与中足峰值压力（p<0.01）和压力时间积分（p<0.01）之间存在显著相关性。未发现其他显著相关性。
结论
临床医生应考虑筛查足下垂和体重指数，作为识别哪些健康老年人可能有中足和前足压力相关并发症风险的简单方法。
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