Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
J Biomech. 2024 Aug;173:112258. doi: 10.1016/j.jbiomech.2024.112258. Epub 2024 Aug 3.
Overuse injuries are often caused by pronated foot and the associated abnormal lower-extremity kinematics during dynamic activities. Various patterns of foot kinematics are observed among individuals with pronated feet during dynamic activities, resulting in different dynamic kinematics of the proximal joint. This study aimed to identify the foot kinematic patterns during gait among individuals with pronated feet and evaluate the relationship between these foot kinematic patterns and the hip and knee kinematics. A three-dimensional motion capture system was used to collect data regarding the foot, knee, and hip kinematics during the stance phase of gait of 42 individuals with pronated feet. A hierarchical cluster analysis method was used to identify the optimal number of clusters based on the foot kinematics, including navicular height (NH) at initial contact and dynamic navicular drop (DND). The differences in the cluster and demographic variables were examined. One-dimensional statistical parametric mapping was used to evaluate the differences in the time histories of the NH, knee, and hip kinematics during the stance phase. Three subgroups were identified on the basis of the NH and DND: Cluster 1, moderate NH at initial contact and larger DND; Cluster 2, highest NH at initial contact and smaller DND; and Cluster 3, lowest NH at initial contact and smaller DND. The hip adduction angle of Cluster 1 was significantly higher than that of Cluster 3 from the 0% to 51% stance phases. Further longitudinal studies are needed to clarify the relationship between identified subgroups and the development of overuse injuries.
过度使用损伤通常是由足旋前和动态活动中相关的下肢异常运动学引起的。在动态活动中,有旋前足的个体观察到各种足运动学模式,导致近端关节的不同动力学运动学。本研究旨在确定旋前足患者在步态中的足运动学模式,并评估这些足运动学模式与髋关节和膝关节运动学之间的关系。使用三维运动捕捉系统收集 42 名旋前足患者在步态支撑阶段的足部、膝盖和髋关节运动学数据。基于足运动学,包括初始接触时的距骨高度 (NH) 和动态距骨下降 (DND),使用分层聚类分析方法确定最佳聚类数量。检查聚类和人口统计学变量的差异。使用一维统计参数映射评估 NH、膝盖和髋关节在支撑阶段的时间历史的差异。基于 NH 和 DND 确定了三个亚组:组 1,初始接触时的中等 NH 和较大的 DND;组 2,初始接触时的最高 NH 和较小的 DND;组 3,初始接触时的最低 NH 和较小的 DND。组 1 的髋关节内收角度从 0%到 51%的支撑阶段显著高于组 3。需要进一步的纵向研究来阐明确定的亚组与过度使用损伤发展之间的关系。