基于足底压力对人体平衡能力的定量评估研究进展

目的 探索足底压力对人体平衡能力的定量评估研究,寻求行之有效、简单易行、可靠性高的描述人体平衡能力的参数指标。方法 基于疾病平衡障碍患者的康复与评估、不同生理状态、不同体育运动,对平衡能力的定量评估研究进行综述。结果 梳理得出基于足底压力对人体平衡能力的定量评估研究中参数指标的不同情形,总结并提出了两组参数指标,一是动力学参数指标,二是运动学参数指标,用以定量评估平衡能力。结论 基于足底压力的定量评估参数指标在大多数情况下能对人体平衡能力的评价提供依据,从而通过锻炼、治疗等手段进一步改善人体平衡能力,减少人体跌倒损伤风险,并有望为足底压力平衡量化分析和相关医疗器械研制提供一定帮助。     

学龄儿童背负不同重量行走时足底压力分布研究

通过Footscan足底压力步态分析系统测试学龄儿童背负不同重量行走时动态足底压力分布进行分析.结果表明,学龄儿童背负4 kg书包行走时,足底第二、三跖趾关节处峰值压力增大,支撑时间延长;压力中心变化曲线呈横向摆动偏大趋势,足中部控制不良需要肢体参与维持平衡;随着背负重量的增加出现足支撑各阶段内外翻的比例加大,造成下肢伤害的可能性增高,说明儿童长期负重行走对足及下肢肌肉负荷较大,足掌跖趾区相应部位易形成胼胝体,将会影响儿童足弓正常发育,应引起社会及家长的重视.建议家长应限制儿童书包重量,避免儿童长时间背负重物行走与站立,应采取有效措施促进学龄儿童身体全面发展.     

平地自然行走护士的步态特征和足底压力分布◆

背景：繁忙的工作和快速行走的严格要求势必造成护士足部压力增高,甚至引起足部疾病。 目的：分析护士平地自然行走下的步态特征和足底压力分布。 方法：采用比利时RSscan INTERNATIONAL公司生产的足底压力分布测试系统对73名护士进行动态足底压力测试。 结果与结论：护士步态分析中足底压强、冲量、支撑时间数据分析一致：在自然步态下,护士足部最大压强部位在第2、3跖骨区;足部最大冲量部位在前足;支撑期时间所占比例最大的是前足离地阶段;加上护士步速较快,足底压力相应增高,前足压力也随其增大。提示护士前足压力较高,易疲劳而发生运动损伤。因此,护士要科学的选择护士鞋或鞋垫,调整足底压力分布和足底冲量,加强对前足、特别是前足第2~3跖骨区的保护,尽可能避免足部疲劳和损伤的发生。     

自然行走对人体足底压力与下肢表面肌电信号影响的研究

目的 探究自然行走对正常人足底压力与下肢肌肉表面肌电信号(sEMG)的影响.方法 分别测量28例健康青年男性受试者在30 min平地自然行走前后足底压力与下肢肌肉的sEMG,得到行走前后峰值压强、冲量等足底压力参数及胫骨前肌、腓肠肌、股直肌与股二头肌的表面肌电时域参数积分肌电(iEMG)和频域参数平均功率频率(MPF),并检验峰值压强与身高、体质量的相关性.结果 平地自然行走开始时和30 min后,其左、右侧的峰值压强、冲量等各特征参数的差异均有统计学意义(均P＜0.05),不同参数的左、右侧差异分别体现在足底不同区域,而在跖骨区M3、M4、M5处各参数均表现出左侧大于右侧;行走前后左侧胫骨前肌、腓肠肌、骨直肌与股二头肌sEMG的iEMG均大于右侧;行走前后左侧胫骨前肌、腓肠肌的MPF大于右侧,其差异具有统计学意义(P＜0.05).30 min行走后右足脚趾区Toe2-5的峰值压强降低,其差异具有统计学意义(P＜0.05);各肌肉表面肌电iEMG无显著性变化,左侧股直肌的表面肌电信号的MPF显著性下降;峰值压强与身高、体质量均呈弱相关.结论 正常人自然行走中,足底压力和下肢表面肌电均具有左右侧的差异;30 min自然行走尚未导致足底压力出现明显疲劳状态的相应结果,因此自然行走30 min可维持步态的稳定性;30 min行走将导致左侧股直肌出现疲劳.     

背包类型对大学生楼梯行走运动学和足底压力的影响

目的 分析不同背包类型和载荷对大学生上楼梯行走时运动学和足底压力的影响,为大学生选择合适的背包及携带方式提供参考。方法 采用Nokov红外光点运动捕捉系统和Podomed足底压力测试系统分析15名男大学生上楼梯支撑期内躯干和下肢关节活动范围、峰值时刻下肢运动学参数、足底各分区压力峰值、接触时间、全足最大压强、平均压强等参数的差异。结果 5%BW和10%BW背包载荷会减小躯干旋转活动范围(range of motion, ROM),增加踝关节屈伸和内外翻ROM,10%BW背包载荷下足底第1、3跖骨压力峰值和全足最大压强提升(P<0.05)。单肩包和手提包减小躯干侧倾和旋转ROM,增大了踝关节屈伸ROM、髋关节屈曲角、足弓和足跟内侧压力峰值(P<0.05)。双肩包负重增加足趾区的压力峰值(P<0.05)。结论 楼梯行走时,5%BW和10%BW背包载荷均会限制躯干旋转,增加踝关节ROM,10%BW载荷还会增加足跖区的负荷。单侧负重模式会使躯干向未负重侧倾斜以及向负重侧旋转。携带双肩包时足趾处的压力较高,而单肩包和手提包主要集中增加足弓和足跟内侧压力。建议大学生群体选择对称性...     

平衡生物反馈训练对脑卒中足内翻患者足底压力和平衡功能的影响

目的 探讨平衡生物反馈训练对脑卒中足内翻患者的足底压力和平衡功能的作用。方法 选择60例脑卒中足内翻患者,其中男性35例,女性25例;年龄50～58岁,平均年龄54.79岁;病程79～92 d,平均病程87.76 d;偏瘫左侧33例,右侧27例;脑梗死31例,脑出血29例。随机选择30例作为对照组,另外30例为试验组。对照组和试验组都进行综合训练,试验组在此基础上进行平衡生物反馈训练。两组连续训练8周,每周5 d,每天2次,每次共60 min。选用美国Tekscan公司的Footscan三维动态足底压力步态分析系统。在治疗前和治疗后8周,对患者的足底压力和平衡运动学参数进行对比。结果 在足底压力方面,治疗前,两组患者内外侧压力和接触面积差异无统计学意义(P> 0.05);治疗后,两组患者内侧压力增大(P <0.05),外侧压力减小(P <0.05)[试验组治疗前后内侧压力(150.18±96.30) N vs (175.70±99.95) N,外侧压力(184.14±85.72) N vs (166.46±112.01) N;对照组治疗前后内侧压力(147.11±74...     

老年男性和年轻男性行走时足底动力学特征差异

目的 比较老年男性和年轻男性在行走时足底动力学特征的差异,探讨增龄对足底动力学的影响.方法 应用鞋垫式压力测试系统比较13名老年男性和14名年轻男性在串联行走时左脚的受压时长、受压支撑百分比、开始受压支撑百分比、结束受压支撑百分比、最大压强、最大压强支撑百分比、平均最大压强、时间压强积分、最大压力、最大压力支撑百分比、...     

老年女性平地自然行走时足底压力指标衰老特征*

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。     

不同年龄段人群行走足底压力特征分析

目的获取不同年龄段人群正常行走时足底压力的动力学参数,为设计制作不同年龄段鞋垫和运动鞋提供理论依据,最大程度减小足部发生损伤的风险。方法使用Footscan测力平板对4个年龄段120名受试者(20～30、30～40、40～50、50～60岁男女各15名)足底压力峰值、压强峰值进行测试。结果足底压力峰值随着年龄增长不断变化,大部分呈上升趋势,只有在第1趾骨区域随着年龄的增长压力峰值逐渐减小,第1趾骨区域女性足底压力峰值在逐渐减小;大部分受试者第2、4拓骨头受力明显高于第1、5跖骨; 50～60岁年龄段男性第2跖骨压力峰值也明显大于20～50岁年龄段人群(P0. 05)。随着年龄增长,仅仅第1趾骨压力峰值逐渐减小,其余区域均呈现增长现象;压强峰值有显著变化,尤其以第2、3跖骨变化最大,呈上升趋势(P0. 05)。结论人体足底各分区的压力、压强随着年龄增长并非一成不变,找出每个年龄段人群足底压力特点,制定相应的运动鞋,才能更好发挥运动鞋的功能。     

大学生不同运动方式下的足底压力分布研究

目的自然行走、慢跑是人类最基本的运动,倒走是一些非特异性腰疼病人进行康复训练的一种运动。了解正常人的步态特征,可以为判定患者步态异常的生物力学研究提供对照。方法选取50名大学生作为研究对象,应用0.5 m footscan~USB足底压力分布测试系统采集受试者自然行走、倒走和慢跑时的步态参数,并应用SPSS 17.0进行数据的统计学分析。结果在3种运动方式下,左右足的支撑期分期均无显著性差异,足弓指数差异明显,足前部所受冲量百分比最大。而慢跑和自然行走相比,足支撑期分期均有显著性差异,T2-T5、M1-M5和MF区域的压强峰值有显著性差异。倒走时,全足支撑期以及足轴角明显大于自然行走和慢跑。结论不同的运动方式改变了足底压力分布状态,在日常运动中,应结合自身体质状况选择运动。     

正走和倒走的膝关节生物力学特征比较

目的 比较正走和倒走两种不同行走模式时膝关节的生物力学特征。方法 采用三维运动捕捉系统Vicon T40和测力台AMTI OR6-7采集并比较13名健康青年男性志愿者正走和倒走时的时间、空间、运动学和动力学参数。结果 与正走相比,倒走时的步速、步频和步幅均显著减小,跨步周期和支撑相所占百分比显著增加;在矢状面上,倒走时膝关节活动度、最大屈伸力矩较正走小;在冠状面上,倒走时膝关节内翻外展活动范围也较正走小,内翻力矩峰值在支撑早期较正走小,但在支撑晚期较正走大;地面反作用力在支撑早期较正走大,但在支撑晚期较正走小。结论 倒走和正走膝关节生物力学特征差异明显。与正走相比倒走在支撑相早期能减轻膝关节内侧间室的负荷,而倒走在支撑相晚期对膝关节负荷的影响则尚须进一步研究。     

Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait

BACKGROUND:

Patellofemoral Pain Syndrome is one of the most common knee disorders among physically active young women. Despite its high incidence, the multifactorial etiology of this disorder is not fully understood.

OBJECTIVES:

To investigate the influence of Patellofemoral Pain Syndrome on plantar pressure distribution during the foot rollover process (i.e., the initial heel contact, midstance and propulsion phases) of the gait.

MATERIALS AND METHODS:

Fifty-seven young adults, including 22 subjects with Patellofemoral Pain Syndrome (30 ± 7 years, 165 ± 9 cm, 63 ± 12 kg) and 35 control subjects (29 ± 7 years, 164 ± 8 cm, 60 ± 11 kg), volunteered for the study. The contact area and peak pressure were evaluated using the Pedar-X system (Novel, Germany) synchronized with ankle sagittal kinematics.

RESULTS:

Subjects with Patellofemoral Pain Syndrome showed a larger contact area over the medial (p = 0.004) and central (p = 0.002) rearfoot at the initial contact phase and a lower peak pressure over the medial forefoot (p = 0.033) during propulsion when compared with control subjects.

CONCLUSIONS:

Patellofemoral Pain Syndrome is related to a foot rollover pattern that is medially directed at the rearfoot during initial heel contact and laterally directed at the forefoot during propulsion. These detected alterations in the foot rollover process during gait may be used to develop clinical interventions using insoles, taping and therapeutic exercise to rehabilitate this dysfunction.     

无症状扁平足与正常足的足底压力和足弓形态对比研究

目的　通过与正常足青年女性对比分析得出无症状扁平足足底压力和足弓形态的特征。 方法　利用Zebris足底压力测量仪对正常足组（12例）和扁平足组（12例）进行直立状态和行走状态下的足底压力测试,并拍摄其负重位和非负重位的侧位X线片进行足弓形态测量,测量数据进行统计学分析。 结果 双足直立时,扁平足组与正常足组的足底压力差异无显著意义（P>0.05）;单足直立时,扁平足组的前足负重比例增大;步行时,扁平足组与正常足组足底压力中心运动轨迹有明显区别。扁平足组负重位与非负重位的足弓形态各参数有显著差异（P<0.05）,而且扁平足组负重位与正常足组负重位的足弓形态有显著差异（P<0.05）。 结论 无症状扁平足单足直立和行走状态的足底压力和足弓形态与正常足相比有明显区别,为评价、诊断和预防无症状扁平足提供定量化数据。     

Muscle activity and heart rate response during backward walking in water and on dry land

The primary purpose of this study was to examine whether walking backward in water and walking backward on dry land elicit different electromyographic (EMG) activities in lower-extremity and trunk muscles. Surface EMG was used to evaluate muscle activities while six healthy subjects walked backward in water (with and without a water current, Water + Cur and Water – Cur, respectively) immersed to the level of the xiphoid process, and while they walked backward on dry land (DL). The trials in water utilized the Flowmill which consists of a treadmill at the base of a water flume. Integrated EMG analysis allowed the quantification of muscle activities. The measurement of maximal voluntary contraction (MVC) of each muscle was made prior to the gait analysis, and all data were expressed as the mean (SD). The %MVCs from the muscles tested while walking backward in water (both with and without a current) were all significantly lower than those obtained while walking backward on dry land ( P<0.05), with the exception of the paraspinal muscles. In the case of the paraspinal muscles, the %MVC while walking backward with a water current was significantly greater than when walking backward on dry land [Water + Cur 19.4 (6.8)%MVC vs. DL 13.1 (1.4)%MVC; P<0.05], or walking backward without a water current [vs. Water – Cur 13.3 (1.8)%MVC; P<0.05]. Furthermore, when walking backward in water, the %MVCs from the muscles investigated were significantly greater in the presence of a water current than without ( P<0.05). In conclusion, walking backward in water with a current elicits the greatest muscle activation of the paraspinal muscles. These data may help in the development of water-based exercise programs.     

拇外翻发病危险因素与足底压力特征

BACKGROUND: Complex anatomic deformity of the foot due to hallux valgus results in the changes of plantar biomechanics. OBJECTIVE: To analyze the risk factors of hallux valgus and to detect the plantar pressure of hallux valgus in natural walking. METHODS: The dynamic plantar pressures of 50 patients and 30 age-, height- and weight-matched normal persons were respectively tested by the Footscan USB2 system (RSscan International, Belgium). All subjects were detected during barefoot walking over three times, to obtain the dynamic plantar pressure curves and characteristic parameters for further analysis. RESULTS AND CONCLUSION: Among patients with hallux valgus, women accounted for 94% (all wearing pointed high-heeled shoes), men accounted for 6% (none wearing pointed high-heeled shoes), and 96% had a genetic history. During the natural walking, the first metatarsal pressure of hallux valgus feet was increased significantly, which markedly differed from the normal people. The average peak pressure, average load, and average impulse of the first metatarsal in hallux valgus patients were significantly increased compared with the normal controls (P < 0.05 or P < 0.01). These results show that wearing high-heeled pointed shoes is another important factor of the hallux valgus in addition to genetic factors. Pressure, load, impulse of the first metatarsal in hallux valgus patients are markedly increased contributing to the occurrence and development of the hallux valgus. All above findings provide an important basis for the prevention, treatment and functional rehabilitation of hallux valgus. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

The effect of foot arch on plantar pressure distribution during standing

Abstract

The aim of this study was to explore how foot type affects plantar pressure distribution during standing. In this study, 32 healthy subjects voluntarily participated and the subject feet were classified as: normal feet (n?=?23), flat feet (n?=?14) and high arch feet (n?=?27) according to arch index (AI) values obtained from foot pressure intensity image analysis. Foot pressure intensity images were acquired by a pedopowergraph system to obtain a foot pressure distribution parameter-power ratio (PR) during standing in eight different regions of the foot. Contact area and mean PR were analysed in hind foot, mid-foot and fore foot regions. One-way analysis of variance was used to determine statistical differences between groups. The contact area and mean PR value beneath the mid-foot was significantly increased in the low arch foot when compared to the normal arch foot and high arch foot (p?<?0.001) in both feet. However, subjects with low-arch feet had significantly higher body mass index (BMI) compared to subjects with high-arch feet (p?<?0.05) and subjects with normal arch feet (p?<?0.05) in both feet. In addition, subjects with low-arch feet had significant differences in arch index (AI) value as compared to subjects with high-arch feet (p?<?0.001) and subjects with normal arch feet (p?<?0.05) in both feet. Mean mid-foot PR value were positively (r?=?0.54) correlated with increased arch index (AI) value. A significant (p?<?0.05) change was obtained in PR value beneath the mid-foot of low arch feet when compared with other groups in both feet. The findings suggest that there is an increased mid-foot PR value in the low arch foot as compared to the normal arch foot and high arch foot during standing. Therefore, individuals with low arch feet could be at high risk for mid-foot collapse and Charcot foot problems, indicating that foot type should be assessed when determining an individual’s risk for foot injury.     

The effects of soccer training and timing of balance training on balance ability

The purpose of the present study was to investigate the effects of a soccer training session on the balance ability of the players and assess whether the effectiveness of a balance program is affected by its performance before or after the regular soccer training. Thirty-nine soccer players were randomly divided into three subject groups (n=13 each), one control group (C group), one training group that followed a balance program (12 weeks, 3 times per week, 20 min per session) before the regular soccer training (TxB group), and one training group that performed the same balance program after the soccer training (TxA group). Standard testing balance boards and the Biodex Stability System were used to assess balance ability in the C, TxB, and TxA groups at baseline (T0) and after completing the balance program (T12). The same tests and additional isokinetic knee joint moment measurements were carried out in the TxB and TxA groups pre- and post-soccer training. Two main results were obtained: (1) No differences (p>0.05) were found in balance ability and knee joint moment production between pre- and post-soccer training. (2) The balance program increased (p<0.01) the balance ability in the TxB and TxA groups, and the improvement in the TxA group was greater (p<0.05) than that in the TxB group post-soccer training. Result (1) is in contrast to the notion of a link between fatigue induced by a soccer training session or game and injury caused by impaired balance, and result (2) has implications for athletic training and rehabilitation.