人体坐姿上肢不同拉力负荷时足底的压力分布

背景:足底压力测量技术已广泛应用于生物力学的步态研究,但多数研究都集中在正常行走或穿各种鞋时的步态时间特征和足底压力分布方面.目的:探讨人体坐姿条件下上肢在不同拉力负荷过程中足底压力分布的特征.方法:应用Seat 16/53 mFLEX 足底压力测试系统记录40 名健康受试者以坐姿在不同拉力负荷条件下的足底压力分布信号,分析在30%,50%,80%,100%最大随意肌力的拉力负荷下,不同年龄及不同性别受试者足底压力的分布.结果与结论:在不同的拉力负荷下,青年组男性受试者的足底压力值明显大于女性(P < 0.05),而中年组男性和女性的足底压力值间差异无显著性意义(P > 0.05).同时,所有受试者均表现出左右足底受力不均一的现象.其中,青年组男性右脚足底压力明显小于左脚,而青年组女性均显示出右脚足底压力大于左脚的情况(P < 0.05).中年组男性和女性左脚的足底压力在30%～80%最大随意肌力拉力负荷下变化不大,但在100%最大随意肌力拉力负荷下明显减小(P < 0.05).说明年龄和性别对不同拉力负荷下人体足底压力均有影响.     

早期康复对缺血性脑卒中患者足底压力分布的影响

目的:观察早期康复对缺血性脑卒中患者足底压力分布的影响,以探讨缺血性脑卒中患者的康复方法和技术。方法:选择15例缺血性脑卒中患者。所有患者均在常规药物治疗的基础上给予康复治疗,内容包括:早期康复程序、肌肉控制能力训练、平衡训练和步态训练等。分别于治疗前24h及治疗后1个月采用Zebris测力板测试足底10个区域(大拇趾、第2—5脚趾、第1—5跖骨、足中部、足跟外侧、足跟内侧)压力峰值的变化,采用Fugl-Meyer下肢运动功能评分量表、Berg平衡量表、修订Barthel指数评分量表评定运动功能。结果:①足底各区域压力平均峰值:治疗后患足各区域压力均有上升,与治疗前比较,以第1跖骨、第3跖骨、足中部和足跟内侧压力上升尤为明显,差异有显著性意义(P<0.01);治疗后健足压力峰值依次出现在足跟内侧、足中部、足跟外侧,其次是第一跖骨,较治疗前压力均有所下降,其中以足跟中部和足跟内侧压力下降明显,差异有显著性意义(P<0.05)。②平衡参数:患者治疗后压力中心轨迹总长度短于治疗之前,治疗前后差异有显著性意义(P=0.05);包络椭圆面积,治疗后数值小于治疗之前,治疗前后差异有显著性意义(P=0.01);压力中心轨迹总长度与包络椭圆面积之比,治疗前比值为2.5±0.4,治疗后比值为0.9±0.2,差异有显著性意义(P<0.01)。③功能评分:治疗后患者下肢运动功能、平衡功能、日常生活活动能力评分均明显提高,差异有显著性意义(P<0.01)。结论:早期康复治疗可明显改善缺血性脑卒中患者的下肢功能和足底压力分布;足底压力测量能为缺血性脑卒中康复治疗提供参考方案。     

人体坐姿上肢不同拉力负荷时足底的压力分布

背景：足底压力测量技术已广泛应用于生物力学的步态研究,但多数研究都集中在正常行走或穿各种鞋时的步态时间特征和足底压力分布方面。目的：探讨人体坐姿条件下上肢在不同拉力负荷过程中足底压力分布的特征。方法：应用Seat16/53mFLEX足底压力测试系统记录40名健康受试者以坐姿在不同拉力负荷条件下的足底压力分布信号,分析在30%,50%,80%,100%最大随意肌力的拉力负荷下,不同年龄及不同性别受试者足底压力的分布。结果与结论：在不同的拉力负荷下,青年组男性受试者的足底压力值明显大于女性（P〈0.05）,而中年组男性和女性的足底压力值间差异无显著性意义（P〉0.05）。同时,所有受试者均表现出左右足底受力不均一的现象。其中,青年组男性右脚足底压力明显小于左脚,而青年组女性均显示出右脚足底压力大于左脚的情况（P〈0.05）。中年组男性和女性左脚的足底压力在30%～80%最大随意肌力拉力负荷下变化不大,但在100%最大随意肌力拉力负荷下明显减小（P〈0.05）。说明年龄和性别对不同拉力负荷下人体足底压力均有影响。     

腰椎间盘突出症患者的足底压力分布研究

目的:探讨患下肢放射痛腰椎间盘突出症(LDH)患者自然行走时的步态特征。方法:选取32例患下肢放射痛LDH患者作为观察组,正常成人31例作为对照组,采用足底压力测量系统对受试者步态进行检测,比较分析2组受试者支撑期分期参数、足底各区域受力时间及足底各区域压力峰值之间的差异。结果:1对照组左右足在支撑期各阶段未见明显差异。观察组患足在前足触地及全足支撑阶段明显低于健侧和对照组,而在前足蹬离阶段明显高于健侧和对照组(P<0.05),健足与对照组在支撑期各阶段差异无统计学意义。2对照组左右足除第4跖骨(M4)区域外,足底各区域受力时间差异无统计学意义。除第5跖骨(M5)区域外,LDH患者患侧足底各区域受力时间均低于健侧(P<0.05),除第3跖骨(M3)区域外,患侧足底各区域受力时间均低于对照组(P<0.05),健足与对照组足底各区域受力时间差异无统计学意义。3对照组左右足除第1跖骨(M1)区域,足底各区域压力峰值差异无统计学意义。除M1区域外,LDH患者患足压力峰值均小于健足,其中在M4、M5、足跟外侧(HL)区域患足压力峰值较健足明显降低(P<0.05),患足在第2跖骨(M2)、M4、M5、足跟内侧(HM)、HL区域及健足在M2区域压力峰值小于对照组(P<0.05)。结论:患下肢放射痛LDH患者足底压力分布具有一定特征性,足底压力测量能为LDH临床诊断、治疗及康复疗效评定提供参考方案。     

腰痛对老年女性动静态平衡功能的影响

摘要 目的：探讨慢性腰痛对老年女性动静态平衡功能的影响。 方法：选取20例老年女性腰痛受试者与20例健康老年女性对照，使用PK 254压力台评估2组受试者在双腿站立睁眼、双腿站立闭眼、单腿站立睁眼时的静态平衡，利用起立步行试验、四格移步试验、10m步行试验评估两组受试者的动态平衡。 结果：与健康对照组相比，老年女性腰痛患者在单腿站立条件下静态平衡控制更差(前后速度P=0.017；左右速度P<0.001；椭圆面积P=0.019；椭圆轨迹P=0.005)，起立步行测试及四格移步测试花费的时间更长(P<0.001)，而在双腿站立、10m步行测试中两组受试者的差别无显著性意义(P>0.05)。 结论：当姿势任务难度增加时，老年女性腰痛患者的平衡控制能力下降，同时单腿站立是评估平衡控制的一项较为敏感的指标。     

健康青年人双足间的距离对静态站立平衡功能的影响

目的 探讨健康青年人静态站立时双足间的距离对平衡功能的影响，为平衡功能训练提供理论基础。 方法 选取健康青年受试者30例，其中男7例，女23例，分别在睁眼和闭眼两种方式下，采用平衡评估训练仪评估双足并拢站立、双足分开（50cm）站立和双足最适距离站立3种模式下的静态平衡功能，即压力中心（COP）的相关参数，包括前后摆动幅度标准差、左右摆动幅度标准差、前后平均运动速度、左右平均运动速度、运动椭圆面积、运动长度共6个量化指标，并进行数据分析。 结果 双足最适距离站立时，双侧足跟间平均距离为（18.63±3.67）cm，双侧足尖间平均距离为（29.60±4.93）cm。在睁眼和闭眼状态下，双足并拢站立时的前后摆动幅度标准差、左右摆动幅度标准差、前后平均运动速度、左右平均运动速度、运动椭圆面积和运动长度与双足分开（50cm）站立和最适距离站立时比较，差异均有统计学意义（P<0.05）；睁眼和闭眼状态下，双足最适距离站立时的左右摆动幅度标准差、左右平均运动速度、运动椭圆面积、运动长度与双足分开（50cm）站立时比较，差异均有统计学意义（P<0.05）。 结论 健康青年人在静态站立时，双下肢间有最适距离，在这种距离下，站立静态平衡功能最佳。     

基于F-Scan三维动态足底压力分析系统的动静态足底压力分析

背景:有研究表明足的部分解剖区域支撑着人体大部分质量,并调节着人体的平衡,测量这些区域的压强峰值及分布即可获取足、下肢乃至全身的生理、结构及功能等方面的大量信息。目的:观察健康青少年足球运动员自然行走时左右足峰力值、负荷冲量等的动态足底压力分布。方法:采用三维动态足底压力步态分析系统对16~19岁适龄青少年足球运动员进行动态足底压力测试。结果与结论:受试者足底应力-时间曲线呈明显的双峰型,足底10个分析区域峰力均值在足跟外侧最大(P<0.01),右足习惯者第1趾、第1,2跖骨、足跟内外侧区域平均峰力值右足大于左足(P<0.05),而第5跖骨、足弓2个区域平均峰力值左足大于右足(P<0.05)。受试者行走时整足接触阶段、离地阶段负荷中心在第1、2跖骨、足跟内外侧区域,足部最大负荷部位在第1、2跖骨、足跟内外侧区域,男女左右足分布规律基本一致。结果证实,健康青少年足球运动员左右足动态与静态足底压力分布规律存在一致性特征。     

平衡反馈训练仪与Berg平衡量表在评定脑卒中偏瘫患者平衡功能中的相关性

目的:探索平衡反馈训练仪与Berg平衡量表在评定脑卒中偏瘫患者平衡功能的相关性。方法:脑卒中偏瘫患者30例,分别进行Pro-Kin平衡仪站立位睁、闭眼静态平衡测试和Berg平衡评估,比较睁、闭眼时平衡仪检测指标重心摆动轨迹长和摆动面积的差异,并分别与Berg平衡量表评分进行Pearson相关性分析。结果:睁眼时重心摆动轨迹长及摆动面积与闭眼时比较,差异均有显著性(P<0.05)。睁眼时重心摆动轨迹长、摆动面积与BBS总分、第6、9项呈中度负相关(r=-0.408—-0.663,P<0.05);重心摆动轨迹长与第8、11—14项,摆动面积与第1、5、7呈中度负相关(r=-0.409—-0.590,P<0.05)。闭眼时摆动面积与第7、8项呈中度负相关(r=-0.492,-0.501,P<0.05);重心摆动轨迹长与Berg总分及子项都不相关。结论:Pro-Kin平衡仪的站立位静态平衡测试时睁眼重心摆动的重心摆动轨迹长及摆动面积可反映脑卒中偏瘫患者的静态平衡能力。     

视觉对行走时足底压力的影响

目的探讨视觉受损者行走时足底压力的分布特征。方法采用比利时Footscan足底压力测试系统对14名正常人(21~26岁)进行睁眼和蒙眼状态下的动态足底压力测试,每名受试者双足各记录5次,计算在睁眼及蒙眼两种状态下双足足底各区域的平均峰值压力值,比较双足峰值压力数据特征。结果与睁眼状态相比,蒙眼行走时双足对应区域的峰值压力差异更为显著,且压力中心向左偏移。结论视觉对行走时的足底压力有明显影响。     

生物力学测力板测量健美操运动员的静态平衡能力

背景:以往研究者对竞技健美操运动员平衡能力的测量采用的方法较为简单,仪器精确性较差,评价也较为粗糙.目的:比较健将级与一级健美操运动员静态平衡能力指标的差别.设计、时间及地点:对比观察,于2006-12/2007-01在南昌大学生物力学实验室完成测试工作.对象:江西师范大学健美操队男子运动员共14人,其中国家健将级6人,国家一级8人,年龄(19.5±5.5)岁,皆连续从事健美操运动训练1年以上,无神经系统、肌肉-骨骼系统及耳鼻喉科病史,无眩晕病史.方法:采用美国AMTI生物力学测力板系统对14名男子竞技健美操运动员进行单足闭眼站立测试.主要观察指标:健将级与一级运动员左脚与右脚静平衡指标比较.结果:①健将级运动员左右脚摆动轨迹长度、平均摆动速率和95%的椭圆面积值均小于一级运动员 (P < 0.01或P < 0.05).左脚矩形面积小于一级运动员(P < 0.01).②健将级运动员左脚X轴方向的最小位移、Y轴方向的最小位移值均大于一级运动员 (P < 0.05或P < 0.01),Y轴方向的最大位移、Y轴方向重心摆动的轨迹长均小于一级运动员 (P < 0.01);右脚除Y轴方向的最大位移值小于一级运动员 (P < 0.05) 外,其余指标均无差异.③健将级运动员左脚X轴方向的最大位移值小于右脚(P < 0.05),Y轴方向的最小位移大于右脚(P < 0.05).一级运动员左脚X轴方向的最大位移、X轴方向重心摆动的轨迹长值及矩形面积均小于右脚(P < 0.01或P < 0.05),单位面积轨迹长大于右脚(P < 0.05).结论:①健将级运动员各静平衡指标明显优于一级运动员,提示健美操训练可能会提高健美操运动员平衡能力.②健将级运动员左脚与右脚静态平衡能力差异不大,但一级运动员左脚的平衡能力优于右脚,提示一级运动员左右脚平衡存在不均衡性.③重心动摇方向的位移,两组运动员主要以Y轴晃动为主.     

足底振动刺激诱发人体特定方向姿势调整的测试系统研究

目的 构建一种能够开展足底皮肤振动刺激对人体姿势控制影响研究的实验测试系统,并验证其有效性。方法 设计制作能够实现振动刺激的机械装置和控制系统,应用生物力学测试方法,于2019年10月2日至6日,对25例健康大学师生开展足底振动刺激实验。选取每位受试者的左足前部、左足后部、右足前部、右足后部、左足、右足、双足前部、双足后部8个振动位置,分别在20 Hz、40 Hz、60 Hz和80 Hz频率下,施加振幅1 mm的振动刺激,对比不同振动条件下的姿势响应情况。结果 足底振动刺激下压力中心响应幅值比与非振动条件下响应幅值有显著性差异(P < 0.05)。结论 测试系统能够对足底不同位置施加不同频率、不同幅值的振动刺激,并且能够采集、分析不同振动条件下受试者压力中心的变化趋势。该系统可以用于足底无毛皮肤振动刺激对于人体姿势控制测试的临床实验研究。     

Thera-band弹力带结合神经肌肉促通技术对偏瘫患者的影响

目的:观察偏瘫患者使用Thera-band弹力带进行两种上肢神经肌肉促通技术(PNF)短时训练时的疗效。方法:脑卒中偏瘫患者28例,测试其训练前安静站立、健手带动患手(方法一)和仅健手(方法二)使用Thera-band弹力带进行PNF D2伸模式训练后足底压力及站位平衡的变化。结果:方法二的患足前半足、整足平均压力低于方法一(P0.05),压力中心偏移的椭圆轨迹长度、椭圆轨迹包络面积高于方法一(P0.05)。结论:方法一较方法二对提高患者患侧前足的受力、增加患侧的整体足底压力、调整身体平衡的改善效果更好。     

脑卒中偏瘫痉挛期患者足底压力与平衡功能的相关性分析

目的：探讨脑卒中偏瘫痉挛期患者的足底压力分布和平衡功能特点及相关性。方法：2020年12月至2022年2月于本院康复科招募脑卒中偏瘫痉挛期患者40例（研究组）和健康中老年志愿者30例（对照组）。2组均进行静、动态的足底压力和睁、闭眼下的平衡功能测试,比较2组足底8个区域压力参数,分析研究组足底压力不对称性与平衡功能的相关程度。结果：研究组中,与非偏瘫侧比较,偏瘫侧静态和动态足跟内侧和外侧的足底压力均明显低于非偏瘫侧（P＜0.05）。与对照组比较,研究组偏瘫侧静态和动态足跟内侧和外侧的足底压力均明显低于对照组（P＜0.05）,动态拇趾足底压力明显低于对照组（P＜0.05）。研究组闭眼状态下平衡测试运动轨迹长度与动态足跟内侧压力差呈正相关（R=0.645,P＜0.05）,与动态足跟外侧压力差呈正相关（R=0.518,P＜0.05）。结论：脑卒中偏瘫痉挛期患者步行时足底压力呈现不对称性,足跟内外侧压力的不对称与平衡运动轨迹长度存在相关性。     

学龄儿童柔软性扁平足足底压力分布特征

目的:探索学龄儿童柔软性扁平足生物力学参数化研究,为临床儿童柔软性扁平足干预方案提供佐证。方法:利用Sensor Media型号为FM6050的压力测试板和freestep pro分析软件采集分析16例6~9岁柔软性扁平足儿童和16例6~9岁正常足弓儿童的站立和步行状态下的足底压力分布数据,探索儿童柔软性扁平足与正常足弓儿童的足底压力分布差异。结果:观察组前足A区(P=0.001)和B区(P=0.009)负荷低于对照组,观察组中足D区(P=0.000)负荷高于对照组。观察组与对照组在步行状态下足底最大冲量存在差异,观察组最大冲量在内侧跟骨,对照足最大冲量在第2、3跖骨,且观察组内侧足弓冲量高于对照组(P=0.002)。结论:学龄儿童因足弓发育的问题导致足底压力分布的异常,即便是无症状的,也是有必要做进一步评估的。监测学龄儿童足底压力,对柔软性扁平足预防和指导康复具有临床意义。     

Immediate Effects of Intermittent Bilateral Ankle Plantar Flexors Static Stretching on Balance and Plantar Pressures

ObjectiveThe purpose of this study was to analyze the immediate effects of an intermittent plantar flexion static-stretching protocol on balance and plantar pressures.MethodsThe study included a sample size of 24 healthy participants (21 female and 3 male). Participants were 32.20 ± 8.08 years, 166.20 ± 8.43 cm, and 62.77 ± 9.52 kg. All participants performed an intermittent plantar flexion static-stretching protocol. Five sets (60 seconds intermittent stretch; 15 seconds for the rest time) of a passive plantar flexor stretching (70% to 90% of the point of discomfort) were performed. Static footprint analysis and a stabilometry analysis were performed before and after stretching. A P value < .05 with a CI of 95% was considered statistically significant for all tests.ResultsIntermittent ankle plantar static stretching resulted in a significantly greater forefoot surface contact area and lower rear foot medium and maximum plantar pressures. In addition, static stretching caused a lower displacement of the center of pressure for both eyes open and eyes closed conditions.ConclusionAn intermittent plantar flexor static-stretching protocol improved balance and reduced rear foot plantar pressures (maximum and medium pressures).     

Region-specific foot pain and plantar pressure in people with rheumatoid arthritis: A cross-sectional study

BackgroundIt is unclear whether region-specific foot pain may influence plantar pressure in people with established rheumatoid arthritis. The aim was to determine the association between region-specific foot pain and region-specific plantar pressure.MethodsTwenty-one people with rheumatoid arthritis and 19 age- and sex-matched controls participated in this study. Self-reported foot pain in the toes, forefoot, midfoot and rearfoot was assessed using foot diagrams. Peak pressure and pressure time integrals for the toes, forefoot, midfoot and rearfoot were calculated using a pressure mat system. Differences in foot pain and pressure between the groups were calculated using appropriate regression models. To determine associations between region-specific pain and pressure, linear regression models were used while adjusting for body mass and participant group.Findings.Participants with rheumatoid arthritis were primarily elderly female with long disease duration. Compared to controls, participants with rheumatoid arthritis had higher odds of foot pain at the toes (Odds Ratio (OR) = 10.4, P = 0.001), forefoot (OR = 6.3, P = 0.006) and rearfoot (OR = 10.1, P = 0.011). Participants with RA had higher peak pressure at the rearfoot (P = 0.003) and higher pressure time integrals at the forefoot (P = 0.005), midfoot (P = 0.016) and rearfoot (P < 0.001). After adjusting for body mass and participant group, peak pressure was significantly higher at the toes in those with midfoot pain and rearfoot pain.InterpretationPeople with rheumatoid arthritis experience region-wide foot pain and demonstrate differences in pressure distribution compared to people without rheumatoid arthritis. Foot pain at the midfoot and rearfoot is also associated with increases in plantar pressure at the toes.     

Impact of foot progression angle on the distribution of plantar pressure in normal children

Background

Plantar pressure distribution during walking is affected by several gait factors, most especially the foot progression angle which has been studied in children with neuromuscular diseases. However, this relationship in normal children has only been reported in limited studies. The purpose of this study is to clarify the correlation between foot progression angle and plantar pressure distribution in normal children, as well as the impacts of age and sex on this correlation.

Methods

This study retrospectively reviewed dynamic pedobarographic data that were included in the gait laboratory database of our institution. In total, 77 normally developed children aged 5–16 years who were treated between 2004 and 2009 were included. Each child's footprint was divided into 5 segments: lateral forefoot, medial forefoot, lateral midfoot, medial midfoot, and heel. The percentages of impulse exerted at the medial foot, forefoot, midfoot, and heel were calculated.

Findings

The average foot progression angle was 5.03° toe-out. Most of the total impulse was exerted on the forefoot (52.0%). Toe-out gait was positively correlated with high medial (r = 0.274; P < 0.001) and forefoot impulses (r = 0.158; P = 0.012) but negatively correlated with midfoot impulse (r = − 0.273; P < 0.001). The moderating effects of age and sex on these correlations were insignificant.

Interpretation

Foot progression angle demonstrates significant impact on the distribution of foot pressure, regardless of age or sex. Foot progression angle should be taken into consideration when conducting pedobarographic examinations and balancing plantar pressure as part of the treatment of various foot pathologies.     

Effects of Kinesio Taping on postural balance in patients with low back pain,a randomized controlled trial

Purpose: to identify postural balance changes in subjects with low back pain after the application of Kinesio Taping, which is then compared to a no treatment control group, using baropodometric evaluation. Methods: This randomized controlled trial was carried out on 50 individuals (both sexes) with chronic low back pain. They were then randomized into two groups: an experimental group - EG (treated with Kinesio Taping in the lumbar region) and a control group - CG (no intervention). Both groups underwent a baropodometric evaluation (mean plantar pressure, peak plantar pressure, plantar surface, mass distribution on right foot and left foot, mass distribution on forefoot and rear foot and base width) at four different moments: pre-intervention, 10 minutes, 48 hours, and 10 days after the intervention on the EG. The level of statistical significance was established at 5%. Results: Significant changes were observed in the EG compared to the CG. In the EG, peak pressure reduced on both right and left foot after Kinesio Taping application; the right base width was reduced, and the mass distribution between the forefoot and the rear foot normalized towards the ideal 50% distribution. These changes happened 48 hours after the Kinesio Taping application, with effects lasting up to 10 days. Conclusion: The use of Kinesio Taping in the lumbar region of subjects with chronic low back pain improved postural balance. This is proved by changes in peak plantar pressure, plantar surface, and mass distribution 48 h after Kinesio Taping application, with effects lasting up to 10 days.     

Classification of forefoot pain based on plantar pressure measurements

Background

Plantar pressure is widely used to evaluate foot complaints. However, most plantar pressure studies focus on the symptomatic foot with foot deformities. The purposes of this study were to investigate subjects without clear foot deformities and to identify differences in plantar pressure pattern between subjects with and without forefoot pain. The second aim was to discriminate between subjects with and without forefoot pain based on plantar pressure measurements using neural networks.

Methods

In total, 297 subjects without foot deformities of whom almost 50% had forefoot pain walked barefoot over a pressure plate. Foot complaints and subject characteristics were assessed with a questionnaire and a clinical evaluation. Plantar pressure was analyzed using a recently developed method, which produced pressure images of the time integral, peak pressure, mean pressure, time of activation and deactivation, and total contact time per pixel. After pre-processing the pressure images with principal component analysis, a forward selection procedure with neural networks was used to classify forefoot pain.

Findings

The pressure–time integral and mean pressure were significantly larger under the metatarsals II and III for subjects with forefoot pain. A neural network with 14 input parameters correctly classified forefoot pain in 70.4% of the test feet.

Interpretation

The differences in plantar pressure parameters between subjects with and without forefoot pain were small. The reasonable performance of forefoot pain classification by neural networks suggests that forefoot pain is related more to the distribution of the pressure under the foot than to the absolute values of the pressure at fixed locations.