基于三维步态分析技术对拇外翻儿童步态变化的研究  

Gait Changes of Children with Hallux Valgus Based on Three-Dimensional Gait Analysis

作　　者：俞艳[1] 姜淑云[1] 李阳[1] 李一瀛 鲁潇莹 Yu Yan;Jiang Shuyun;Li Yang;Li Yiying;Lu Xiaoying(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中国运动医学杂志》2021年第4期259-264,共6页Chinese Journal of Sports Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划项目[ZY(2018-2020)-CCCX-2004-06]。

摘　　要：目的:比较拇外翻儿童与正常儿童步态模式的差异,探究拇外翻对儿童步态的影响。方法:选取拇外翻儿童(拇外翻组)和正常儿童(正常组)各25名。运用运动捕捉系统采集两组儿童步行时的三维步态数据,主要包括足、踝、膝及髋关节的运动学数据,地面反作用力及时-空参数等。结果:与正常组的步态数据相比,拇外翻组步速(P=0.004)、步频(P=0.034)、步长(P=0.041)减小;支撑相平均足外偏角度减小(P=0.001),支撑相末期踝关节最大背屈角度增加(P=0.026)、膝关节最小屈曲角度增加(P=0.009)及髋关节最大伸展角度减小(P=0.010);垂直方向地面反作用力第2峰值减小(P<0.001)。结论:儿童拇外翻足第1跖趾关节的结构异常造成支撑相末期前足轴的运动稳定性下降,从而引起踝、膝及髋关节在支撑相末期的运动异常,步行效率下降。步行时足外偏角度的减小可引起膝、髋关节的异常应力增加,潜在的关节损伤风险提高。Objective To explore the impact of hallux valgus(HV) on children’s gait by comparing the difference in gait data between the HV and normal children. Methods A total of 25 HV children were selected into an HV group, while another 25 normal counterparts were chosen into a normal group. The three-dimensional motion capture system was used to collect gait data of the hip,knee and ankle joint,as well as ground reaction forces,temporal and spatial parameters while walking. Results Compared with the normal group,a significant decrease was observed in the average walking velocity,cadence and step length of the HV group respectively(P=0.004,P=0.034 and P=0.041). A significant decrease was also observed in the average foot progression average angle during the stance phase(P=0.001). Moreover,in the terminal stance phase,there was a significant increase in the average maximum ankle dorsiflexion angle(P=0.026) and minimum knee flexion angle(P=0.009),but a significant decrease in the average maximum hip flexion angle(P=0.010) of the HV group. And the second peak value of the ground reaction force in the vertical plane was significantly lower than the control group(P<0.001). Conclusion The structural abnormality of the first metatarsophalangeal joint of HV children results in the decrease of the motion stability of the forefoot axis at the terminal stance phase,which results in the motion abnormality and the decrease of walking efficiency of the ankle,knee and hip joints. The reduction of foot progression angle during walking increases the abnormal stress of knee and hip joints and their potential risk of injury.

关 键 词：拇外翻 儿童 步态分析 

分 类 号：R725.8[医药卫生—儿科]