Bhatia Aanchal, Ajoy Shiv Manik, Galagali Dev Anand, Debur Ramesh
Max Super Speciality Hospital, New Delhi, India.
Department of Orthopaedics, Ramaiah Medical College, Bangalore, India.
Foot Ankle Spec. 2024 Jul 26:19386400241265547. doi: 10.1177/19386400241265547.
There are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity. In this study, we aim to compare the activities of quadriceps, hamstrings, and gastrosoleus muscle groups of adult patients with PCFD with normal lower limbs and correlate the radiological parameters and functional effects of PCFD with the activities.
Thirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch.
Electrical activities of all muscle groups were significantly higher in cases than controls. Meary's angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041).
The PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association.
Diagnostic: Level 3.
在进行性塌陷足畸形（PCFD）谱系中描述了各种畸形，这些畸形不仅对足部有不良影响，而且对整个下肢也有影响。PCFD患者最常见的主诉是早期下肢肌肉在运动时疲劳和疼痛。表面肌电图（sEMG）可准确评估肌肉活动。在本研究中，我们旨在比较患有PCFD的成年患者与下肢正常的成年患者的股四头肌、腘绳肌和腓肠肌肌群的活动情况，并将PCFD的放射学参数和功能影响与这些活动相关联。
30例双侧PCFD患者和30例对照者接受了足部负重前后位（AP）、侧位和后足对线X线片检查。评估PCFD的放射学参数。使用表面肌电图评估股四头肌、腘绳肌和腓肠肌的活动，并在两组之间进行比较，并与PCFD的放射学测量结果相关联。使用Tegner活动问卷评估足弓塌陷的功能影响。
所有肌肉群的电活动在病例组中均显著高于对照组。Meary角和后足力矩臂分别与腘绳肌活动（P = .013）和腓肠肌活动（P = .027）有显著相关性。病例组的Tegner评分显著低于对照组（P = .041）。
PCFD导致受影响下肢的大肌肉活动增加，这些肌肉作用于足部以外的关节。这一发现可能是由于几种抵消变形力的代偿机制。这可能是导致频繁抱怨、早期疲劳以及功能障碍的原因。然而，大多数放射学参数与肌肉活动无相关性，可能需要更大的研究样本量以进行进一步的关联研究。
诊断性：3级。
