功能性踝关节不稳足底压力分析

doi:10.3969/j.issn.1006-9771.2022.10.013

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (10): 1217-1223.doi: 10.3969/j.issn.1006-9771.2022.10.013

功能性踝关节不稳足底压力分析

王建国¹,唐佳^2,³,董继革²(),陈亚平¹()

1.首都医科大学附属北京同仁医院康复医学科,北京市 100176
2.中国中医科学院望京医院康复治疗中心,北京市 100102
3.天津体育学院社会体育与健康科学学院,天津市 303617

收稿日期:2022-03-25 修回日期:2022-08-24 出版日期:2022-10-25 发布日期:2022-11-08
通讯作者: 董继革,陈亚平 E-mail:yishengd2010@sina.com;yaping_chen0725@sina.com
作者简介:王建国(1989-),男,汉族,山东莱芜市人,硕士研究生,医师,主要研究方向：神经系统损伤和疾病康复、骨科康复。|唐佳(1994-),女,汉族,江苏淮安市人,硕士研究生,初级康复治疗师,主要研究方向：骨科康复、神经康复。|董继革(1967-),女,北京市人,汉族,主任治疗师,主要研究方向：神经、骨关节疾病康复。|陈亚平(1964-),女,汉族,主任医师,主要研究方向：神经、骨关节疾病康复。

Analysis of plantar pressure for functional ankle instability

WANG Jianguo¹,TANG Jia^2,³,DONG Jige²(),CHEN Yaping¹()

1. Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
2. Department of Rehabilitation Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
3. Faculty of Social Sports and Health Sciences, Tianjin University of Sport, Tianjin 303617, China

Received:2022-03-25 Revised:2022-08-24 Published:2022-10-25 Online:2022-11-08
Contact: DONG Jige,CHEN Yaping E-mail:yishengd2010@sina.com;yaping_chen0725@sina.com

摘要/Abstract

摘要：

目的观察功能性踝关节不稳(FAI)患者的足底压力分布特征。

方法 2021年1月至7月,采用Freestep足底压力分析系统对北京同仁医院FAI患者20例进行足底压力测试,并进行健、患侧之间的比较。

结果双足睁眼站立时,患侧前足负荷占体重比小于健侧(t = 2.251, P = 0.036),后足负荷占体重比大于健侧(t = 2.251, P = 0.036);单足睁眼站立时,患侧平均纵向移动距离(Y)明显大于健侧(t = 3.271, P < 0.01);单足闭眼站立时,患侧球长度、椭圆面积、平均速度、平均Y均明显大于健侧(t > 3.140, P < 0.01)。行走时,患侧内侧足跟的受力面积和负荷大于健侧(t > 2.260, P < 0.05),患侧的前足和后足受力负荷分布与健侧不同(t = 2.153, P < 0.001),患侧足的最大压强和平均压强显著小于健侧(t > 5.005, P < 0.001),患侧压力中心连线增量及压力中心连线占脚印长度比例显著大于健侧(t > 20.567, P < 0.001)。

结论 FAI患者双足站立时,患侧前后足重心分布不均匀;单足支撑时,姿势控制稳定性弱,尤其是闭眼状态下;行走时,患侧动态稳定性较差。

关键词: 功能性踝关节不稳, 足底压力, 稳定性

Abstract:

Objective To observe the distribution characteristics of plantar pressure of patients with functional ankle instability (FAI).

Methods From January to July, 2021, the Freestep plantar pressure analysis system was used to measure plantar pressure of 20 patients with FAI in Department of Rehabilitation, Beijing Tongren Hospital. The data beteen the healthy side and the affected side were compared.

Results When standing with both feet and eyes open, the weight ratio of the forefoot load was less (t = 2.251, P = 0.036), and the weight ratio of the hindfoot load was more (t = 2.251, P = 0.036) in the affected side than in the healthy side. When standing with the affected foot and eyes open, the average longitudinal distance (Y) was more in the affected side than in the healthy side (t = 3.271, P< 0.01); when standing with the affected foot and eyes closed, the length of the ball, the area of the ellipse, the average speed, and the average Y were more in the affected side than in the healthy side (t > 3.140, P< 0.01). When walking, the force area and load of the medial heel were more (t > 2.260, P < 0.05), the maximum pressure and average pressure were significantly less (t > 5.005, P < 0.001), and the line increment of the pressure center and the ratio of foot gait line length/footprint length were significantly more (t > 20.567, P < 0.001) in the affected side than in the healthy side. The contribution of loads of both forefoot and hindfoot was significantly different from the health side (t = 2.153, P < 0.001).

Conclusion For patients with FAI, when standing with both feet, the center of gravity of the affected side is more unevenly distributed; when standing with the affected foot, the posture control stability is obviously weaker, especially when the eyes are closed; when walking, the dynamic stability of the affected side is worse.

Key words: functional ankle instability, plantar pressure, stability

中图分类号:

R684.7

王建国,唐佳,董继革,陈亚平. 功能性踝关节不稳足底压力分析[J]. 《中国康复理论与实践》, 2022, 28(10): 1217-1223.

WANG Jianguo,TANG Jia,DONG Jige,CHEN Yaping. Analysis of plantar pressure for functional ankle instability[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(10): 1217-1223.

图/表 7

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侧别	n	前足面积/cm²	后足面积/cm²	前足负荷/%	后足负荷/%	前足负荷占体重比/%	后足负荷占体重比/%
健侧	20	47.95±15.46	41.00±9.38	23.35±6.49	26.95±8.15	46.90±13.70	53.10±13.70
患侧	20	46.20±16.85	41.75±8.63	21.15±7.32	28.55±5.74	42.10±12.43	57.90±12.43
t值		0.900	0.521	1.327	0.905	2.251	2.251
P值		0.379	0.608	0.200	0.377	0.036	0.036

状态	侧别	n	球长度/mm	椭圆面积/mm²	平均速度/mm·s^-1	平均X/mm	平均Y/mm
睁眼	健侧	20	371.24±71.00	411.26±324.96	26.99±5.57	0.41±3.69	13.02±7.75
	患侧	20	392.73±82.42	341.93±410.11	29.15±7.75	0.23±32.12	17.65±7.56
闭眼	健侧	20	646.58±122.18	1723.75±910.67	50.78±11.48	14.55±67.65	7.29±7.99
	患侧	20	859.94±343.30	5700.82±12769.24	71.68±7.75	1.41±87.48	18.72±11.44
	t值^a		0.980	0.692	1.200	0.027	3.271
	P值^a		0.339	0.498	0.245	0.979	0.004
	t值^b		3.141	3.323	3.140	0.504	3.911
	P值^b		0.005	0.001	0.005	0.620	0.001
	t值^c		6.086	1.873	5.640	0.078	0.441
	P值^c		< 0.001	0.077	< 0.001	0.939	0.664

足底区域	健侧	患侧	t值	P值
第1足趾	11.33±3.01	10.08±2.70	1.328	0.200
第2~5足趾	2.94±3.05	1.93±2.12	0.853	0.394
第1跖骨	9.91±4.19	9.94±3.70	0.026	0.979
第2~3跖骨	16.85±4.90	16.28±3.45	0.538	0.596
第4~5跖骨	15.76±3.54	15.54±3.27	0.244	0.810
内侧足弓	1.58±1.39	1.81±1.43	0.944	0.345
外侧足弓	12.64±4.61	11.29±4.65	1.048	0.308
内侧足跟	13.46±3.27	15.24±3.57	2.260	0.036
外侧足跟	14.74±2.90	14.03±2.34	0.946	0.356

足底区域	健侧	患侧	t/Z值	P值
第1足趾	9.51±4.54	8.03±2.93	1.730	0.100
第2~5足趾	2.80±5.29	1.46±1.75	1.023	0.306
第1跖骨	9.51±3.90	9.57±4.09	0.060	0.953
第2~3跖骨	19.80±5.49	18.73±3.91	0.836	0.413
第4~5跖骨	16.61±4.85	15.68±3.88	0.724	0.478
内侧足弓	1.25±1.60	1.48±1.29	0.966	0.334
外侧足弓	9.43±3.93	8.70±4.44	0.630	0.536
内侧足跟	15.40±4.56	19.23±5.06	3.008	0.007
外侧足跟	15.77±2.75	17.02±4.82	0.848	0.407

侧别	前足负荷	后足负荷	内侧负荷	外侧负荷
健侧	63.45±5.98	36.55±5.98	45.85±6.90	54.15±6.90
患侧	58.55±7.86	41.45±7.86	48.40±5.90	51.60±5.90
t值	2.153	2.153	1.753	1.753
P值	0.044	0.044	0.080	0.080

功能性踝关节不稳足底压力分析

Analysis of plantar pressure for functional ankle instability

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侧别	最大压强	平均压强
健侧	2334.80±405.95	939.85±116.35
患侧	1938.60±324.05	824.95±115.85
t值	6.340	5.005
P值	< 0.001	< 0.001

侧别	压力中心连线增量/mm	压力中心连线占脚印长度比/%
健侧	194.25±29.36	80.15±8.74
患侧	203.75±21.59	85.35±5.34
t值	28.306	20.567
P值	< 0.001	< 0.001

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