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1.
摘要 目的:探讨偏瘫患者不同站立姿势下足底压力的变化及对平衡功能的影响。 方法:选择24例偏瘫患者,要求每位患者在Novel Zebris压力测试平板上,分别以四种姿势站立,即双足并拢、双足左右分开、健足在前患足在后,以及患足在前健足在后站立,测试患者在四种不同站立姿势下的压力峰值、平均压力、压力中心偏移的椭圆轨迹长度,以及椭圆轨迹包络面积。 结果:①压力峰值:双足分开较双足并拢站立时,健侧前半足和后半足压力峰值均有明显下降(P<0.05);患足在前较患足在后站立时,患足压力峰值明显下降(P<0.05)。②平均压力值:双足分开较双足并拢站立时,健侧前半足平均压力明显下降,后半足平均压力明显提高(P<0.05),但患侧前半足和后半足平均压力变化不大(P>0.05);健侧和患侧整足平均压力无明显变化(P>0.05);患足在前较患足在后站立时,健足平均压力明显提高,患足平均压力明显下降(P<0.05)。③压力中心偏移的椭圆轨迹长度和椭圆面积:双足分开较双足并拢站立时椭圆面积明显下降(P<0.05),椭圆轨迹长度明显增加(P<0.05),椭圆轨迹长度与椭圆面积比值明显下降(P<0.05);患足在前较患足在后站立时,椭圆面积明显下降(P<0.05),椭圆轨迹长度与椭圆面积比值明显下降(P<0.05)。 结论:①四种常见的站立姿势中,患足在前站立时健患足平均压力较其它三种站立姿势有明显差异,双足并拢、双足分开、健足在前站立时健患足平均压力几乎一致。②四种站立姿势中,双足分开站立时患者的平衡稳定性最好。  相似文献   

2.
目的:研究脑卒中后偏瘫患者常速行走时的足底压力特点。方法:选取21例能独立行走的脑卒中慢性期偏瘫患者,17例健康中老年人,测量并分析其常速行走时双足的最大压力、冲量、支撑时间、着地、离地顺序等。结果:1最大压力、冲量:患者健侧中足及足跟、第2—5趾的压力较健康人大(P0.05),第1趾压力较健康人小(P0.05);患侧中足及足跟压力较健康人大(P0.05),前足内侧、第1趾和第2—5趾压力较健康人小(P0.05)。患者健患侧中足及足跟的冲量较健康人大(P0.05),前足内侧冲量较健康人小(P0.05)。患者健侧与患侧各区的足底压力、冲量差异无显著性(P0.05)。2支撑相时间:患者健患侧足趾、中足及足跟的支撑时间较健康人延长(P0.05),患者健侧与患侧的支撑时间无差异(P0.05)。3着地和离地顺序:健康人表现为从足跟、中足至足趾的连续推进过程,脑卒中患者则无统一规律。4脑卒中偏瘫患者足底压力曲线形态异常。结论:慢性脑卒中偏瘫患者的健侧与患侧足底压力特征相同,前足的压力及冲量小于健康人,中足及足跟的压力及冲量大于健康人。慢性脑卒中偏瘫患者前足、中足及足跟的支撑时间较健康人增加。足的着地、离地顺序差异较大,无统一规律。足底压力曲线形态不规则。  相似文献   

3.
目的观察脑梗死偏瘫患者跑台步行中足底压力与步行周期的特点。方法 2017年4月至2018年11月,脑梗死偏瘫患者24例采用FDM-T步态分析系统进行步态分析,比较患侧与健侧的步行周期、足底压力分布与足底时空变化参数的差异。结果患侧较健侧站立相明显缩短(t=-3.343, P 0.01),以站立中期较明显(t=-3.241, P 0.01);迈步相明显延长(t=3.342, P 0.01);中足最大力(t=-2.513, P 0.05)、中足接触时间(t=-2.631, P 0.05)减小;足偏角明显增大(t=3.072, P 0.01)。结论增强患侧站立负重和立位平衡功能训练以延长站立相,加强站立中期膝关节控制能力,纠正患侧踝关节跖屈、内翻和足偏角,有利于改善脑梗死偏瘫患者步行能力和步态。  相似文献   

4.
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。  相似文献   

5.
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。  相似文献   

6.
目的探讨单侧下肢放射痛腰椎间盘突出症患者自然行走时的步态特征及足底压力检测系统的重测信度。方法采用足底压力测量系统测试32例单侧下肢放射痛腰椎间盘突出症患者步行时的动态足底压力共5次,分析受试者健、患足支撑期分期参数、足底各区域受力时间及足底各区域压力峰值之间的差异及重测信度。结果患足前足触地及全足支撑阶段明显低于健侧,而前足离地阶段明显高于健侧(P0.01)。除第5跖骨区域外,患足足底各区域受力时间均低于健足(P0.05)。在第4、第5跖骨及足跟外侧区域,患足压力峰值较健足降低(P0.05)。上述参数组内相关系数均0.76。结论单侧下肢放射痛腰椎间盘突出症患者足底压力分布具有一定特征,足底压力检测系统在步态参数测量中具有较高的重测信度。  相似文献   

7.
目的:探讨早期坐-站训练对亚急性脑卒中偏瘫患者平衡功能的影响。方法:44例亚急性不能独立完成坐-站转移的脑卒中偏瘫患者随机分为2组各22例,均接受常规康复治疗,对照组给予常规辅助下坐-站转移训练;观察组患者采用患足置后下辅助坐-站转移训练。训练前后采用Berg平衡量表(BBS)评估2组患者的平衡功能、AL-080平衡功能评估系统测试2组患者训练前后坐位静态下压力中心点的轨迹长(SLsi)、坐位稳定极限下压力中心点的最大面积(SAsi)、训练后独立完成坐-站转移时间(T)、双下肢负重差异(ALD)、足底压力峰值(Fmax)以及站立静态下压力中心点的轨迹长(SLst)、站立稳定极限下压力中心点的最大面积(SAst)。结果:训练2周后,2组SLsi评分均较训练前明显下降(P<0.01),且观察组更低于对照组(P<0.05);2组SAsi及BBS评分均较训练前明显提高(P<0.01),且观察组更高于对照组(P<0.05)。训练后, 观察组完成坐-站转移所需的时间、健侧下肢负重及ALD评分均明显低于对照组(P<0.05),观察组患侧下肢负重、Fmax及动态SAst评分均明显高于对照组(P<0.05);2组SLst评分比较差异无统计学意义。结论:早期坐-站转移训练能更好地促进脑卒中偏瘫患者平衡功能提高,且采用患足置后下坐-站转移训练效果更佳。  相似文献   

8.
目的:探讨踝足矫形器(AFO)对脑卒中偏瘫患者步行时单支撑期足底压力峰值及步行功能的影响。方法:选取脑卒中偏瘫患者38例作为研究对象,分别在其裸足与穿戴踝足矫形器时,采用步态与平衡功能评测系统进行步态测试,观察并计算步速、双下肢摆动相时间、单支撑期双下肢足底压力峰值,以及偏瘫步态不对称指数等参数,分析单支撑期足底压力峰值与步速及偏瘫步态不对称指数的相关性。结果:穿戴AFO前后比较,患者步行速度分别为(0.47±0.05)m/s及(0.63±0.04)m/s,偏瘫步态不对称指数为(0.19±0.07)及(0.15±0.02),偏瘫侧单支撑期足底压力峰值为(1.03±0.04)及(1.07±0.02),差异均有显著性意义(P0.05)。即穿戴AFO后,患者步行速度提高,偏瘫步态不对称指数减少,偏瘫侧单支撑期足底压力峰值较前增大。穿戴AFO后,偏瘫侧单支撑期足底压力峰值与步速呈正相关(r=0.417,P0.01),与偏瘫步态不对称指数呈负相关(r=-0.748,P0.01)。结论:脑卒中偏瘫患者佩戴AFO步行时,足底压力相关参数发生改变,偏瘫侧单支撑期足底压力峰值增大,且其与步速和偏瘫步态不对称性间存在相关性。  相似文献   

9.
目的 观察矫形弹力绷带改善痉挛性偏瘫脑瘫患儿步态对称性和步行能力的短期疗效。方法 2020年6月至2023年6月,北京博爱医院痉挛性偏瘫脑瘫患儿31例,随机分为对照组(n=15)和试验组(n=16)。两组均接受常规康复治疗,此外,对照组采用常规步行训练,试验组佩戴矫形弹力绷带进行步行训练,共4周。训练前后,计算足偏角比(患侧足偏角/健侧足偏角)、步长比(患侧步长/健侧步长)、步态线长比(患侧步态线长/健侧步态线长)和站立阶段比(患侧站立阶段百分比/健侧站立阶段百分比);测量步宽和10米步行测试(10MWT)速度。结果 试验组脱落1例。训练后,两组足偏角比、步长比、步态线长比和站立阶段比均改善(|t|> 2.434, P <0.05),且试验组优于对照组(|t|> 2.230, P <0.05);两组10MWT自选速度和最大速度均显著提高(|t|>9.186, P <0.001),且试验组高于对照组(|t|> 2.278, P <0.05)。结论 佩戴矫形弹力绷带训练能有效改善痉挛性偏瘫脑瘫患儿的步态对称性和步行能力。  相似文献   

10.
摘要 目的:探讨不同模式本体感觉神经肌肉促进技术(PNF)干预对功能性踝关节不稳患者平衡能力的影响。 方法:通过踝关节功能评价量表(ankle joint functional assessment tool, AJFAT)筛选出22位功能性踝关节不稳(functional ankle instability, FAI)的男性在校大学生,随机分成试验组与对照组,分别对两组患者进行4周站立位PNF干预和4周仰卧位PNF干预,两种体位分别采用弹力带施阻和徒手施阻。在干预前后对所有患者的踝关节功能评价问卷评分、闭目单脚站立实验、T型敏捷性测试(agility T-Test)、星状伸展平衡实验(star excursion balance tests, SEBT)进行评定,并于干预结束1个月后对患者进行随访。本实验结果采用意向性治疗分析和符合方案集分析。 结果:干预前两组患者组内健患侧间闭目单脚站立时间和SEBT评定结果存在显著差异(P<0.05)。干预4周后,试验组与对照组的AJFAT评分和Agility T-Test结果较干预前有显著提高(P<0.05),两组受试者患侧静态平衡能力较干预前有显著提高(P<0.05),试验组健侧静态平衡能力明显增强(P<0.05),SEBT中两组患侧间比较,干预后前内(Anteromedial, AMED)方向差异有显著性意义(P<0.05)。随访结果显示,停止干预1个月后,两组受试者闭目单脚站立时间较干预前无明显变化(P>0.05),AJFAT评分较干预前明显提高(P<0.05)。 结论:FAI患者的患侧下肢平衡能力弱于健侧;4周常规PNF干预与4周站立位PNF干预对于改善FAI患者下肢动态和静态平衡能力都有良好的作用;站立位PNF干预对健侧平衡能力以及患侧动态平衡能力改善的作用优于常规PNF干预。  相似文献   

11.
目的 探讨可描述脑卒中偏瘫患者步行支撑期足内翻的足底压力学参数。 方法 选取能独立步行的脑卒中偏瘫患者22例设为病例组,另选与患者年龄、体重相匹配的中老年健康志愿者17例设为对照组,使用Footscan压力板测量受试者常速行走下的足底压力,采集双足各3次的动态足底压力,得到足内外侧压强比值,记录并分析患者行走时足底各区域的压强峰值和接触面积(本研究所呈现的数据均为某个区域参数相对于所有分区对应参数之和的百分比)。并使用临床痉挛指数(CSI)评价患者患侧踝关节的痉挛程度,并比较对照组健康人与病例组患者健患侧之间上述参数的差异及其相关性。 结果 ①病例组患侧前足内侧压强占所有分区之和的百分比[(23.52±10.15)%]小于对照组优势侧[(29.82±7.45)%],而前足外侧压强的百分比[(45.45±17.71)%]大于对照组优势侧[(37.47±12.60)%];病例组健侧第1趾压强的所占百分比[(9.04±7.47)%]小于对照组优势侧[(14.84±6.54)%],而病例组中足及足跟压强的所占百分比[患侧(38.17±13.57)%,健侧(49.61±26.36)%]均大于对照组优势侧[(25.05±4.92)%],且组间差异均有统计学意义(P<0.05);病例组患侧前足外侧压强的所占百分比[(45.45±17.71)%]大于组内患者健侧[(37.04±22.09)%],且差异有统计学意义(P<0.05)。②病例组患侧第1趾接触面积占全足的百分比[(9.96±1.67)%]大于对照组优势侧[(8.57±1.17)%],前足内侧接触面积占全足的百分比[(14.71±4.64)%]小于对照组优势侧[(17.62±1.52)%],且组间差异均有统计学意义(P<0.05);病例组其余各区域健患侧组内比较,差异无统计学意义(P>0.05)。③病例组患侧全足、前足内外侧压强比值最大值[(27.21±22.73)、(22.81±22.19)]明显小于对照组优势侧[(43.68±23.78)、(41.09±28.13)],组间差异均有统计学意义(P<0.05),而足跟的足内外侧压强比值的最大值组间比较以及健患侧之间全足、前足及足跟足内外侧压强比值的最大值比较,差异均无统计学意义(P>0.05),但有患侧小于对照组优势侧及患侧小于健侧的趋势(P>0.05)。④病例组健患侧足在支撑期翻转程度减小,整体呈内翻。⑤病例组经CSI评定有轻度痉挛13例,中度痉挛5例,重度痉挛4例。病例组患侧总体的踝关节CSI得分(10.26±3.38)分,95%可信区间位于8.63~11.89。病例组患侧全足的内外侧压强比值最大值与前足外侧压强呈中度负相关(r=-0.516,P<0.05),与接触面积及CSI无关(P>0.05)。 结论 足底压力可定量描述脑卒中偏瘫患者的足内翻,足内外侧压强比值的最大值是反映脑卒中偏瘫患者足内翻的有效指标。  相似文献   

12.
OBJECTIVE: High plantar pressure is an acknowledged risk factor in the development of plantar ulcers in the diabetic neuropathic foot. This study examines the ability of preventive foot care (PFC) socks to reduce plantar foot pressures in a sample of high-risk patients with diabetes. RESEARCH DESIGN AND METHODS: Nineteen patients with established peripheral neuropathy attending a complications clinic of the Manchester Diabetes Centre were recruited to the study. Fifteen (78%) of the patients were male, 40-80 years of age, and ulcer-free at the time of recruitment. In-shoe plantar pressure measurements were recorded using the F-Scan and compared PFC socks with ordinary supermarket socks. The analysis measured differences in maximum foot contact area and plantar pressure for the whole foot, forefoot, and peak plantar pressure areas. RESULTS: The results showed a significant increase in maximum foot contact area of 11 cm2 (95% CI 7-11) when subjects wore the PFC socks (P < 0.01). This was accompanied by 5.4 kPa (3.5-7.3) or 9% reduction in total foot pressure (P < 0.01). Similar results were observed at the forefoot, which showed a 14.2% increase in contact area and a 10.2% reduction in peak forefoot pressure. CONCLUSIONS: These results suggest that the wearing of PFC socks increases the underfoot contact area and hence decreases plantar foot pressures. Further studies are required to determine whether the pressure and friction reductions achieved by this simple intervention would be effective in reducing the incidence of foot ulcers in high-risk patients.  相似文献   

13.
OBJECTIVES: The aim of this study was to analyse, firstly, the plantar pressure distribution in healthy subjects in order to validate or invalidate the previous studies results on the asymmetrical profile of the stance phase. The studies of asymmetries was based on the identification of a propulsive foot and a loading foot from a concept introduced by Viel. Secondly, the approach was applied to the study of gait asymmetries in two children with hemiplegic cerebral plasy. MATERIAL AND METHOD: Thirty healthy control subjects and two hemiplegic children (H1 and H2) performed a walking test at self selected speed. The recordings of dynamic parameters were realized thanks to an in-shoe plantar pressure analysis system (Parotec, by Paromed Medizintechnik, GMBH, Germany). The pressure peaks were determined from the recording of pressures under eight footprint locations. A program calculated the sum of forces under the heel and determined the loading foot. By defect, the second foot is the propulsive foot. RESULTS: The asymmetrical profile of the human normal stance phase was validated. Under the heel, the pressure peaks lower by 28 % were noticed beneath the loading foot compared to the propulsive foot. Inversely, under the metatarsal heads and the hallux, the pressure peaks were greater by 32 % beneath the propulsive foot. For the two hemiplegic children, the plantar pressure profile equally highlighted significant differences between the unaffected and affected feet. The pressure peaks under the affected heel were respectively lower by 21 % and 97 % for H1 and H2. The loading function was found and associated to the affected limb. The propulsive function was not systematically found under the unaffected foot. DISCUSSION: The analysis of plantar pressure measurements during able-bodied gait showed differences between the two lower limbs. These dynamic asymmetries are the results of a natural functional organization of the supports differentiating a loading foot and a propulsive foot and corroborating the concept proposed by Viel. The hemiplegic gait also presented dynamic asymmetries partially agreement with a personalized functional logic of loading and propulsion. However, the asymmetrical profile can also result a gait self-optimization strategy compensating biomechanical, anatomical and physiological disorders linked to the cerebral deficiency.  相似文献   

14.
目的:采用足底压力分析技术对正常年轻人的睁眼、闭眼状态下的姿势控制进行评估,旨在研究视觉输入对于静态平衡功能的影响。方法:选取66例健康成年人作为研究对象,指示受试者站立于FreeMed足底压力分析测试板固定位置。测试者按前、后、左、右4个方向摆动受试者骨盆,使受试者双脚压力均匀分布。先后进行睁眼和闭眼状态监测,分别记录足底压力数据30 s。使用Freestep足底压力分析系统对已采集足底压力原始数据进行预处理,得出球长度、椭圆面积、平均速度、平均X、平均Y、椭圆倾斜角、椭圆偏心角、最大摆动、最小摆动和左右双侧下肢的足底整体负荷、前足负荷和后足负荷。结果:在睁眼和闭眼2种状态下受试者的椭圆面积(P<0.05)、平均Y(P<0.001)和最大摆动(P<0.001)的差异均有统计学意义。对比睁眼状态,闭眼时正常人的椭圆面积减小,平均Y减小,而最大摆动增加。根据足底压力中心(COP)的散点图分布情况,发现睁眼状态下COP分布较闭眼状态下集中。对比睁眼和闭眼2种状态,受试者的左脚前足负荷(P<0.001)、右脚前足负荷(P<0.001)、左脚后足负荷(P<0.001)和右脚后足负荷(P<0.001)的差异均有统计学意义。闭眼状态较睁眼状态下左脚前足负荷和右脚前足负荷均有增加,而左脚后足负荷和右脚后足负荷均有减少。在左侧下肢与右侧下肢2种状态对比中,受试者的睁眼状态左脚整体负荷较右侧下肢减少(P=0.030);在闭眼状态下左脚整体负荷也比右侧下肢减少(P=0.021),差异有统计学意义。由前足和后足在睁闭眼2种状态的对比中可见,受试者的后足负荷均明显大于前足负荷(P<0.001),差异有统计学意义。结论:视觉输入作用于椭圆面积和摆动幅度,影响静态平衡功能维持;本研究通过足底压力分析的运动学和动力学参数量化评估平衡功能,力求能为临床评估提供方向。  相似文献   

15.

Background

The purpose of this study was to investigate the ankle range of motion during neuropathic gait and its influence on plantar pressure distribution in two phases during stance: at heel–strike and at push-off.

Methods

Thirty-one adults participated in this study (control group, n = 16; diabetic neuropathic group, n = 15). Dynamic ankle range of motion (electrogoniometer) and plantar pressures (PEDAR-X system) were acquired synchronously during walking. Plantar pressures were evaluated at rearfoot, midfoot and forefoot during the two phases of stance. General linear model repeated measures analysis of variance was applied to investigate relationships between groups, areas and stance phases.

Findings

Diabetic neuropathy patients walked using a smaller ankle range of motion in stance phase and smaller ankle flexion at heel–strike (P = 0.0005). Peak pressure and pressure–time integral values were higher in the diabetic group in the midfoot at push-off phase when compared to heel–strike phase. On the other hand, the control group showed similar values of peak pressure in midfoot during both stance phases.

Interpretation

The ankle mobility reduction observed could be associated to altered plantar pressure distribution observed in neuropathic subjects. Results demonstrated that midfoot and forefoot play a different role in subjects with neuropathy by receiving higher loads at push-off phase that are probably due to smaller ankle flexion at stance phase. This may explain the higher loads in anterior areas of the foot observed in diabetic neuropathy subjects and confirm an inadequate foot rollover associated to the smaller ankle range of motion at the heel–strike phase.  相似文献   

16.
The purpose of this study was to determine whether a relationship existed between type of foot deformity and the location of ulcers in patients with diabetes and insensitive feet. Forty-two ulcerated feet were examined in 40 patients. All patients had severely decreased or absent sensation. Foot deformities were classified according to operational definitions as 1) Charcot's foot, 2) a compensated forefoot varus, or 3) an uncompensated forefoot varus or forefoot valgus. The plantar surface of the midfoot and forefoot was divided into three regions. Six of the 7 patients with a Charcot's foot showed ulceration at the midfoot. Nine of 18 patients with a compensated forefoot varus showed ulceration at the second, third, or fourth metatarsal head. Fifteen of 17 patients with an uncompensated forefoot varus or forefoot valgus showed ulceration at the first or fifth metatarsal. A significant relationship was found between foot deformity and location of ulcer. These results support the hypotheses 1) that insensitivity, coupled with increased, repetitive pressure, is a primary cause of plantar ulcers and 2) that certain foot types are associated with characteristic patterns of pressure distribution and callus formation.  相似文献   

17.

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.  相似文献   

18.
背景:有研究表明步态特征的变化及步行稳定性下降是引发老年女性跌倒的主要原因。目的:观察老年女性步行时足底压力特征随年龄增长情况,为监测人体运动系统衰老进程提供基线数据。方法:选取40~50岁中年及70~75岁老年女性各45名为研究对象,应用高频足底压力测试系统进行测试,观察时相、冲量、足轴角、足内外翻等指标的变化。结果与结论:平地自然走时,老年组支撑期各阶段时间均大于中年组。老年组步行时,离地阶段所占支撑时期小于中年组(P<0.05),着地阶段、前掌接触阶段所占支撑时期大于中年组(P<0.05)。中年组足底所受冲量最大的部位是第2,3跖骨,老年组足底所受冲量最大的部位是第3,4跖骨,两组左右双足的分布规律基本一致。行走时老年组的足轴角明显大于中年组足轴角(P<0.05);足内翻例数(13例)多于中年组(5例)。结果证实,老年女性行走较中年女性缓慢;支撑期中,离地阶段比例变短,着地阶段比例变长是增龄性变化特征。老年与中年女性最易疲劳和损伤的部位在足前掌中部,老年女性更容易以八字脚姿态行走,同时易出现足内翻现象。  相似文献   

19.
Effect of sock on biomechanical responses of foot during walking   总被引:3,自引:0,他引:3  
BACKGROUND: Except the plantar pressure and gross joint motion, we know little about the mechanical state of a foot during walking. This study aimed at investigating the effect of wearing socks with different frictional properties on plantar shear, which is a possible mechanical risk factor of foot lesion development. METHOD: A 3-D finite element model for simulating the foot-sock-insole contact was developed to investigate the biomechanical effects of wearing socks with different combinations of frictional properties on the plantar foot contact. The dynamic plantar pressure and shear stress during the stance phases of gait were studied through finite element computations. Three cases were simulated, a barefoot with a high frictional coefficient against the insole (0.54) and two socks, one with a high frictional coefficient against the skin (0.54) and a low frictional coefficient against the insole (0.04) and another with an opposite frictional properties assignment. FINDINGS: Wearing sock of low friction against the insole to allow more relative sliding between the plantar foot and footwear was found to reduce the shear force significantly: at the rearfoot from 3.1 to 0.88 N, and at the forefoot from 10.61 to 1.61 N. The shear force can be further reduced to 0.43 N at the rearfoot, and 1.18 N at the forefoot, when wearing the sock with low friction against the foot skin and high friction set against the insole. INTERPRETATION: Wearing sock with low friction against the foot skin was found to be more effective in reducing plantar shear force on the skin than the sock with low friction against the insole. The risk of barefoot walking in developing plantar shear related blisters and ulcers might be reduced by socks wearing especially those with low friction against the foot skin.  相似文献   

20.
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.  相似文献   

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