体表感觉训练对前交叉韧带重建术后患者足偏角和足底冲量的影响

doi:10.3969/j.issn.1006-9771.2022.09.014

Abstract

Abstract:

Objective To observe the effect of surface sensation training on walking function of patients after anterior cruciate ligament reconstruction (ACLR).
Methods From January to November, 2021, 56 ACLR inpatients in Beijing Rehabilitation Hospital were randomly divided into control group (n = 28) and experimental group (n = 28). The control group received routine rehabilitation training of 45 minutes a time, while the experimental group received routine rehabilitation training of 30 minutes and surface sensation training of 15 minutes a time, for eight weeks. Their toe-out angle and affected side impulse percentage of plantar seven zones were measured before and after intervention.
Results The toe-out angle of both the healthy and the affected sides decreased in both groups after intervention (t > 4.615, P < 0.001), and it was less in the affected side in the experimental group (t = 2.263, P < 0.05). The impulse percentage in heel medial and heel lateral areas increased in both groups after intervention (t > 4.221, P< 0.001), and it was more in the experimental group (t > 3.651, P< 0.01); while the impulse percentage in middle foot, foot intermediate and foot lateral areas decreased in both groups (t > 3.174, P < 0.01), and it was less in foot intermediate and foot lateral areas in the experimental group (t > 2.366, P< 0.05); the impulse percentage decreased in foot medial and toe areas in the experimental group (t > 3.508, P < 0.01), but there was no significant difference between two groups (t < 1.608, P > 0.05).
Conclusion Surface sensation training can further improve the foot deflection and distribution of impulse of affected side in patients after ACLR during walking, to normalize the load patterns.

Key words: anterior cruciate ligament reconstruction, surface sensation training, walking, toe-out angle, impulse

CLC Number:

R686

MA Yubao,WANG Chenxi,GAO Weiguang,FAN Zhijiao,MA Quansheng,SUN Fenglong. Effects of surface sensation training on foot deflection and plantar impulse after anterior cruciate ligament reconstruction[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1096-1103.

Figures/Tables 18

References 33

[1]	ŚMIGIELSKI R, ZDANOWICZ U, DRWIĘGA M, et al. The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction[J]. Bone Joint J, 2016, 98B(8): 1020-1026.
[2]	FILBAY S R, GRINDEM H. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture[J]. Best Pract Res Clin Rheumatol, 2019, 33(1): 33-47. doi: S1521-6942(19)30019-1 pmid: 31431274
[3]	YAO S, FU B S, YUNG P S. Graft healing after anterior cruciate ligament reconstruction (ACLR)[J]. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2021, 25: 8-15. doi: 10.1016/j.asmart.2021.03.003 pmid: 34094881
[4]	GOETZ G, DE VILLIERS C, SADOGHI P, et al. Allograft for anterior cruciate ligament reconstruction (ACLR): a systematic review and meta-analysis of long-term comparative effectiveness and safety. Results of a health technology assessment[J]. Arthrosc Sports Med Rehabil, 2020, 2(6): e873-e891. doi: 10.1016/j.asmr.2020.07.003
[5]	SLATER L V, HART J M, KELLY A R, et al. Progressive changes in walking kinematics and kinetics after anterior cruciate ligament injury and reconstruction: a review and meta-analysis[J]. J Athl Train, 2017, 52(9): 847-860. doi: 10.4085/1062-6050-52.6.06
[6]	BUCKTHORPE M, DANELON F, LA ROSA G, et al. Recommendations for hamstring function recovery after ACL reconstruction[J]. Sports Med, 2020, 51(4): 607-624. doi: 10.1007/s40279-020-01400-x
[7]	PANG M, YANG L, OUYANG H, et al. Dual-task exercise reduces cognitive-motor interference in walking and falls after stroke[J]. Stroke, 2018, 49(12): 2990-2998. doi: 10.1161/STROKEAHA.118.022157 pmid: 30571419
[8]	MIKO S C, SIMON J E, MONFORT S M, et al. Postural stability during visual-based cognitive and motor dual-tasks after ACLR[J]. J Sci Med Sport, 2021, 24(2): 146-151. doi: 10.1016/j.jsams.2020.07.008 pmid: 32773174
[9]	VAN DE WINCKEL A, DE PATRE D, RIGONI M, et al. Exploratory study of how Cognitive Multisensory Rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke[J]. Sci reports, 2020, 10(1): 1-11.
[10]	GIORDANO K, CHAPUT M, ANZ A, et al. Knee kinetics in baseball hitting and return to play after ACL reconstruction[J]. Int J Sports Med, 2021, 42(9): 847-852. doi: 10.1055/a-1236-4102
[11]	GUIOTTO A, CINIGLIO A, SPOLAOR F, et al. Reliability and repeatability of ACL quick check: a methodology for on field lower limb joint kinematics and kinetics assessment in sport applications[J]. Sensors (Basel), 2021, 22(1): 259. doi: 10.3390/s22010259
[12]	MARZETTI E, RABINI A, PICCININI G, et al. Neurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: a single-blind randomized controlled clinical trial[J]. Eur J Phys Rehabil Med, 2014, 50(3): 255.
[13]	PARK J. The effects of plantar perception training on balance and falls efficacy of the elderly with a history of falls: a single-blind, randomized controlled trial[J]. Arch Gerontol Geriatr, 2018, 77: 19-23. doi: 10.1016/j.archger.2018.03.014
[14]	NAKANO H, NOZAKI M, UETA K, et al. Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(7): 608-615. doi: 10.1177/0269215512471062 pmid: 23405022
[15]	姜焯文. 基于静动态平衡能力的人体稳定性评价方法研究[D]. 天津: 天津科技大学, 2020.
	JIANG Z W. Study on the method of human stability evaluation based on the static and dynamic balance[D]. Tianjin: Tianjin University of Science and Technology, 2020.
[16]	曹方园, 徐俊凯, 胡海, 等. 跑步时足偏角对胫骨冲击影响的探索性研究[J]. 医用生物力学, 2019, 34(2): 207-212.
	CAO F Y, XU J K, HU H, et al. Exploration study about influence of foot progression angle on tibial shock during running[J]. J Med Biomed, 2019, 34(2): 207-212.
[17]	潘永雄, 陈锦, 王大伟, 等. 足底压力测试系统的常用步态分析指标[J]. 临床医学工程, 2018, 25(9): 1267-1269.
	PAN Y X, CHEN J, WANG D W, et al. The common gait analysis indicators of plantar pressure system[J]. Clin Med Engineer, 2018, 25(9): 1267-1269.
[18]	顾琳燕, 邱华平, 张晟宇, 等. 正常人群步行足偏角与年龄特征分析[J]. 生物医学工程学杂志, 2018, 35(1): 45-48.
	GU L Y, QIU H P, ZHANG S Y, et al. Analysis of the relevance of age and toe out angle of normal adults' gait[J]. J Biomed Engineer, 2018, 35(1): 45-48.
[19]	吴剑, 李建设. 人体行走时步态的生物力学研究进展[J]. 中国运动医学杂志, 2002(3): 305-307.
	WU J, LI J S. Progress in biomechanics of human gait during walking[J]. Chin J Sports Med, 2002(3): 305-307.
[20]	TAZAWA M, SOHMIYA M, WADA N, et al. Toe-out angle changes after total knee arthroplasty in patients with varus knee osteoarthritis[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(12): 3168-3173. doi: 10.1007/s00167-014-2841-8
[21]	BEHLING A V, MANZ S, VON TSCHARNER V, et al. Pronation or foot movement: what is important[J]. J Sci Med Sport, 2020, 23(4): 366-371. doi: 10.1016/j.jsams.2019.11.002
[22]	黄红拾, 敖英芳, 郭秦炜, 等. 前交叉韧带重建术影响步行时足底压力时相特征初步研究[J]. 中国运动医学杂志, 2014, 33(3): 189-192.
	HUANG H S, AO Y F, GUO Q W, et al. Preliminary study on the change in temporal plantar pressure during walking after ACL reconstruction[J]. Chin J Sports Med, 2014, 33(3): 189-192.
[23]	李玉周, 王婧怡, 胡英琪. 前交叉韧带重建术后短期足底压力分布及平衡特征研究[J]. 体育科学, 2020, 40(5): 52-59.
	LI Y Z, WANG J Y, HU Y Q. Short-term plantar pressure distribution and balance after anterior cruciate ligament reconstruction[J]. Sports Sci, 2020, 40(5): 52-59.
[24]	杜天舒, 成西侠, 张春礼, 等. 前交叉韧带损伤患者动态足底压力变化[J]. 中国运动医学杂志, 2016, 35(6): 520-526.
	DU T S, CHENG X X, ZHANG C L, et al. Change in plantar pressure of patients with anterior cruciate ligament deficient during walking[J]. Chin J Sports Med, 2016, 35(6): 520-526.
[25]	黄浩然, 陈俊, 王思哲, 等. 足部空间姿态评估分析系统在ACL重建前后步态分析中的应用[J]. 中国骨与关节损伤杂志, 2018, 33(12): 1255-1258.
	HAUNG H R, CHEN J, WANG S Z, et al. Analysis of gait before and after anterior cruciate ligament reconstruction using foot space pose assessment system[J]. Chin J Bone Joint Injury, 2018, 33(12): 1255-1258.
[26]	张燊. 足部功能训练对足弓形态及跑步生物力学影响的研究[D]. 上海: 上海体育学院, 2020.
	ZHANG S. The effects of the functional foot exercise on the arch shape and running biomechanics[D]. Shanghai: Shanghai University of Sport, 2020.
[27]	ZHANG Z, WANG L, HU K, et al. Characteristics of plantar loads during walking in patients with knee osteoarthritis[J]. Med Sci Monit, 2017, 23: 5714-5719. doi: 10.12659/MSM.905136
[28]	GENC Y, GULTEKIN A, DUYMUS T M, et al. Pedobarography in the assessment of postoperative calcaneal fracture pressure with gait[J]. J Foot Ankle Surg, 2016, 55(1): 99-105. doi: 10.1053/j.jfas.2015.07.018 pmid: 26364236
[29]	REES H W. Management of osteoarthritis of the hip[J]. J Am Acad Orthop Surg, 2020, 28(7): e288-e291. doi: 10.5435/JAAOS-D-19-00416
[30]	LEE S, BAE S, JEON D, et al. The effects of cognitive exercise therapy on chronic stroke patients' upper limb functions, activities of daily living and quality of life[J]. J Phys Ther Sci, 2015, 27(9): 2787-2791. doi: 10.1589/jpts.27.2787 pmid: 26504294
[31]	DE PATRE D, VAN DE WINCKEL A, PANTÉ F, et al. Visual and motor recovery after "Cognitive Therapeutic Exercises" in cortical blindness: a case study[J]. J Neur Phys Ther, 2017, 41(3): 164-172.
[32]	MORIOKA S, FUJITA H, HIYAMIZU M, et al. Effects of plantar perception training on standing posture balance in the old old and the very old living in nursing facilities: a randomized controlled trial[J]. Clin Rehabil, 2011, 25(11): 1011-1020. doi: 10.1177/0269215510395792 pmid: 21504952
[33]	NAKANO H, NOZAKI M, UETA K, et al. Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(7): 608-615. doi: 10.1177/0269215512471062 pmid: 23405022

项目	对照组 (n = 28)	试验组 (n = 28)	χ²/t值	P值
性别(男/女)/n	13/15	12/16	0.072	0.788
年龄/岁	30.23±7.76	30.43±7.43	0.102	0.919
身高/m	1.69±0.09	1.72±0.08	0.660	0.420
体质量/kg	68.60±9.68	69.30±11.10	1.614	0.209
BMI/kg·m^-2	23.79±1.94	23.40±2.00	1.088	0.281
患病部位(左/右) /n	11/17	13/15	0.292	0.589
术后时间(≤ 7周/> 7周) /n	16/12	13/15	0.644	0.422

组别	n	干预前	干预后	t值	P值
对照组	28	12.26±3.65	9.94±1.96	4.615	< 0.001
试验组	28	13.20±2.42	9.49±2.51	9.490	< 0.001
t值		1.179	0.779
P值		0.243	0.439

组别	n	干预前	干预后	t值	P值
对照组	28	14.14±3.25	11.21±2.19	5.561	< 0.001
试验组	28	14.48±3.52	9.69±2.29	8.793	< 0.001
t值		0.388	2.623
P值		0.699	0.011

组别	n	干预前	干预后	t值	P值
对照组	28	13.54±2.51	15.61±2.77	4.221	< 0.001
试验组	28	13.23±3.33	19.13±2.97	24.603	< 0.001
t值		0.414	4.749
P值		0.680	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	28	11.03±2.27	15.61±2.94	12.624	< 0.001
试验组	28	11.75±3.65	18.51±3.22	20.377	< 0.001
t值		0.920	3.651
P值		0.362	0.001

Effects of surface sensation training on foot deflection and plantar impulse after anterior cruciate ligament reconstruction

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 18

References 33

Related Articles 15

Metrics

Comments

Recommended 0

组别	n	干预前	干预后	t值	P值
对照组	28	14.96±4.99	11.18±5.49	7.676	< 0.001
试验组	28	13.89±5.17	9.83±5.08	15.434	< 0.001
t值		0.811	0.990
P值		0.420	0.362

组别	n	干预前	干预后	t值	P值
对照组	28	11.21±2.43	10.56±2.51	1.655	0.190
试验组	28	12.64±3.68	9.45±2.84	9.795	< 0.001
t值		1.773	1.608
P值		0.081	0.113

组别	n	干预前	干预后	t值	P值
对照组	28	28.00±3.10	26.64±2.74	3.174	0.004
试验组	28	27.01±3.62	24.35±3.01	9.551	< 0.001
t值		1.136	3.080
P值		0.260	0.003

组别	n	干预前	干预后	t值	P值
对照组	28	12.81±1.44	10.54±1.82	7.915	< 0.001
试验组	28	12.61±2.29	9.44±1.79	10.348	< 0.001
t值		0.401	2.366
P值		0.690	0.021

组别	n	干预前	干预后	t值	P值
对照组	28	8.88±4.04	9.29±3.63	1.153	0.136
试验组	28	8.46±3.61	9.86±3.31	3.508	0.001
t值		0.424	0.632
P值		0.673	0.530

[1]	WEI Mengli, ZHONG Yaping, ZHOU Yiwen, GUI Huixian, GUAN Yeming, YU Tingting. Difference in bilateral lower limb muscle synergy mode for gait in patients after unilateral anterior cruciate ligament reconstruction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 95-104.
[2]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[3]	MA Shengnan, KE Jingyue, DONG Hongming, LI Jianping, ZHANG Honghao, LIU Chao, SHEN Shuang, LI Guqiang. Effect of core stability training on dynamic balance and surface electromyography after anterior cruciate ligament reconstruction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 882-889.
[4]	SUN Zhijie, GUO Xin, LAN Zhi, WANG Qiang. Turn intention perception and fall detection for smart walkers [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 849-855.
[5]	TAN Xiaohuan, JIANG Guiping, HUANG Xinyi, WANG Dandan, ZHANG Lei, BU Qingguo, WU Xueping. Relationship between lower limb muscle strength and walk speed in community dwelling older adults: the chain mediating role of flexibility and dynamic balance [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 646-653.
[6]	ZHANG Qian, SUN Xinting. Effect of video-based mirror therapy on lower limb motor function of stroke patients at recovery stage [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 703-707.
[7]	ZHAO Yaxian, TANG Zhiqing, SUN Xinting, WANG Rongrong, LIU Tianhao, ZHANG Hao. Effects of different intensity of wearable lower limb rehabilitation robot-assisted training on lower limb function after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 497-503.
[8]	JIN Zhenhua, CHEN Ling, LIU Yong. Effect of self-efficacy-based intelligent walking training on function of lower extremities of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 504-509.
[9]	WANG Lu, CHEN Yan, SU Jiulong, DU Zhiwei, YU Rui, HU Nan, ZENG Yiming, YU Mianxuan, HONG Jing. Effect of three-dimensional motion platform training on balance and walking function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 485-490.
[10]	MA Qishou, LI Zhongyuan, FU Weiwei, LIN Qian. Effect of repetitive transcranial magnetic stimulation on walking of stroke patients at recovery stage [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 167-173.
[11]	WEI Tianqi, LUO Jiaqi, LI Zijuan, WU Xueliang, XU Panpan, ZHANG Yanmei, ZHAO Xiaomeng, WU Qinfeng. Effect of augmented reality training based on enriched environment on walking function after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(12): 1439-1445.
[12]	CHEN Xinyu,WU Shiwen. Participation of rehabilitation for patients with Duchenne muscular dystrophy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1089-1095.
[13]	CHAI Li,WANG Mei. Effect of track body weight support walking training on lower limb motor function in stroke patients: based on ICF Core Set for Stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 653-658.
[14]	ZHU Lin,CHANG Dongmei,WANG Ya'nan,LIU Yuanmin,LIU Huilin. Effect of simple knee trainer on knee active flexion for hemiplegics after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 356-360.
[15]	KE Jingyue,MA Shengnan,ZHANG Xiaohui,LI Guqiang. Biomechanical differences of adolescent idiopathic scoliosis during static standing and level walking: a meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(10): 1178-1189.