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。

Study on plantar pressure in patients with lumbar disc herniation

Objective: To investigate the gait features of patients with lumbar disc herniation suffering from the low back pain radiating into the unilateral lower limb during normal walking. Methods: The study was carried out among 32 patients with lumbar disc herniation suffering from the low back pain radiating into the unilateral lower limb as the observation group, and 31 healthy adults as the control group. Footscan plantar system was used in the gait phase, the contacting time of every plantar region and max force analysis between the two groups. Result: (1) There was no significant difference in the gait phase between the left and right lower limbs of the healthy adults. In the forefoot contact phase and foot flat phase, the figures of patients on the affected sides were obviously lower, while obviously higher than those in the forefoot push off phase on the healthy sides and control group (P<0.05), and no significant difference was found between the healthy sides in the observation group and control group in the gait phase. (2) Except for the region of M4, there was no significant difference in the contacting time of every plantar region between the left and right lower limbs of control group. Except for the region of M5, the contacting time of every plantar region on the affected sides of observation group was shorter than that on the healthy sides (P<0.05). Except for the region of M3, the contacting time of every plantar region on the affected sides was shorter than in control group (P<0.05). No significant difference was found between the healthy sides in observation group and control group; (3) Except for the region of M1, there was no significant difference in the max force between the left and right lower limbs of control group. In the regions such as M4, M5, and heel lateral, the max force on the affected sides of observation group was lower than that on the healthy sides (P<0.05), and that on the affected sides in M2, M4, M5, heel lateral, heel medial and the healthy sides in M2 was lower than in control group (P<0.05). Conclusion: Differences were found in the above three gait parameters between the two groups. Footscan plantar system can be a valuable tool for testing the gait of patients with lumbar disc herniation and serve as a reference for rehabilitation interventions for such patients.