Kerrigan D C, Abdulhadi H M, Ribaudo T A, Della Croce U
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Arch Phys Med Rehabil. 1997 Oct;78(10):1085-91. doi: 10.1016/s0003-9993(97)90132-5.
A previous study demonstrated that when one knee is artificially immobilized, a contralateral shoe-lift improves the oxygen cost of walking. This study was undertaken to evaluate the kinematic and kinetic effects associated with this shoe-lift.
Motion analysis and force platform data were collected in subjects walking (1) normally, (2) with one knee immobilized, (3) with one knee immobilized and with a one-half-inch shoe-lift applied to the contralateral, nonimmobilized shoe, and (4) with a one-inch shoe-lift similarly applied. Kinematic and kinetic data from three trials of each condition were compared graphically and statistically using a repeated measures analysis of variance.
A gait laboratory.
Eight able-bodied subjects without known neurologic or musculoskeletal problems.
Fifty-two peak kinematic and kinetic variables during various phases of the gait cycle.
Statistically significant differences (p < .05) between the normal and immobilized knee conditions were noted in 22 variables; however, significant differences between the immobilized knee conditions were found in only 4 variables. There were small improvements with the shoe-lifts toward normal in peak hip abduction, hip abduction at 20% to 30% of the gait cycle, and in peak knee extension moment on the nonimmobilized side. There was a small change away from normal in peak knee extension moment on the immobilized-side for the 1" shoe-lift.
Wearing a contralateral shoe-lift when one knee is immobilized is associated with only small changes in kinematic and kinetic parameters. The shoe-lift may slightly reduce the need for compensatory hip abduction and vaulting on the nonimmobilized side. Importantly, no adverse biomechanic effect from the shoe-lift was noted except for a slightly increased peak knee extension moment on the immobilized side found for the 1" but not the 1"/2 shoe-lift.
先前的一项研究表明，当一侧膝关节被人为固定时，对侧鞋底加垫可降低行走时的氧耗。本研究旨在评估与这种鞋底加垫相关的运动学和动力学效应。
收集受试者在以下四种情况下行走时的运动分析和测力平台数据：（1）正常行走；（2）一侧膝关节固定；（3）一侧膝关节固定且对侧未固定的鞋子上加垫半英寸；（4）同样加垫一英寸。使用重复测量方差分析对每种情况的三次试验的运动学和动力学数据进行图形化和统计学比较。
步态实验室。
八名无已知神经或肌肉骨骼问题的健康受试者。
步态周期各阶段的52个运动学和动力学峰值变量。
正常和膝关节固定情况之间在22个变量上存在统计学显著差异（p <.05）；然而，膝关节固定情况之间仅在4个变量上存在显著差异。鞋底加垫后，在非固定侧的峰值髋关节外展、步态周期20%至30%时的髋关节外展以及峰值膝关节伸展力矩方面，有向正常情况的小幅度改善。对于一英寸的鞋底加垫，固定侧的峰值膝关节伸展力矩有小幅度偏离正常的变化。
一侧膝关节固定时穿对侧鞋底加垫仅与运动学和动力学参数的微小变化相关。鞋底加垫可能会略微减少非固定侧代偿性髋关节外展和跳跃的需求。重要的是，除了一英寸（而非半英寸）鞋底加垫导致固定侧峰值膝关节伸展力矩略有增加外，未发现鞋底加垫有不良生物力学效应。
