Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran.
Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran.
BMC Musculoskelet Disord. 2023 Jul 4;24(1):547. doi: 10.1186/s12891-023-06678-2.
BACKGROUND & PURPOSE: Afferent input from the sole affects postural stability. Cutaneous reflexes from the foot are important to posture and gait. Lower-limb afferents alone provide enough information to maintain upright stance and are critical in perceiving postural sway. Altered feedback from propreoceptive receptors alters gait and patterns of muscle activation. The position and posture of the foot and ankle may also play an important role in proprioceptive input.Therefore, the current research aims to compare static balance and ankle and knee proprioception in people with and without flexible flatfeet.
91 female students between the ages of 18 and 25 voluntarily participated in this study, of which 24 were in the flexible flatfoot group and 67 were in the regular foot group after evaluating the longitudinal arch of the foot. The position sense of ankle and knee joints were measured using the active reconstruction test of the ankle and knee angle; Static balance was measured using the Sharpened Romberg test. Data were non-normally distributed. Accordingly, non-parametric tests were applied. The Kruskal-Wallis test was applied to compare differences between groups in variables.
Kruskal-Wallis test showed a significant difference between two groups of flat feet and normal feet in the variables of static balance and position sense of ankle plantarflexion, ankle dorsiflexion, and knee flexion (p ≤ 0.05). A significant correlation was found between static balance and sense of ankle and knee position in the group with normal feet. The analysis of the regression line also showed that ankle and knee position sense could predict the static balance score in the regular foot group (ankle dorsiflexion position sense 17% (R = 0.17), ankle plantarflexion position sense 17% (R = 0.17) and knee flexion position sense 46% (R = 0.46) explain of changes in static balance).
DISCUSSION & CONCLUSION: Flexible flatfoot soles can cause loss of balance and sense of joint position; therefore, according to this preliminary study, clinicians must be aware and should take into account this possible deficit in the management of these patients.
来自足底的传入输入会影响姿势稳定性。足部的皮肤反射对于姿势和步态很重要。仅下肢传入即可提供维持直立姿势所需的足够信息，并在感知姿势摆动方面至关重要。本体感受感受器的反馈改变会改变步态和肌肉激活模式。足和踝关节的位置和姿势也可能在本体感受输入中发挥重要作用。因此，目前的研究旨在比较有和无弹性平足的人之间的静态平衡和踝关节及膝关节本体感觉。
本研究共纳入 91 名年龄在 18 岁至 25 岁之间的女性学生，其中 24 名患有弹性平足，67 名患有正常足，对足弓进行评估后分组。使用踝关节和膝关节角度主动重建试验测量踝关节和膝关节关节位置觉；使用 Sharpened Romberg 试验测量静态平衡。数据呈非正态分布。因此，应用了非参数检验。Kruskal-Wallis 检验用于比较两组之间的变量差异。
Kruskal-Wallis 检验显示，在静态平衡和踝关节跖屈、背屈以及膝关节屈曲位置觉的变量中，扁平足组和正常足组之间存在显著差异（p≤0.05）。在正常足组中，静态平衡与踝关节和膝关节位置觉之间存在显著相关性。回归线分析还表明，踝关节和膝关节位置觉可以预测正常足组的静态平衡评分（踝关节背屈位置觉 17%（R=0.17）、踝关节跖屈位置觉 17%（R=0.17）和膝关节屈曲位置觉 46%（R=0.46）解释了静态平衡的变化）。
弹性平足会导致平衡丧失和关节位置感丧失；因此，根据这项初步研究，临床医生必须意识到这一点，并在管理这些患者时考虑到这种可能的缺陷。
