创伤性伸直型膝关节挛缩患者动态足底压力分布规律研究  

Distribution Pattern of Dynamic Plantar Pressure in Patients with Traumatic Extension Knee Contracture

作　　者：熊斌[1,2] 周云 王华[3] 张全兵 刘奕[1,2] 李凯[1,2] 郑浩然 王婧[2] 王取南 XIONG Bin;ZHOU Yun;WANG Hua;ZHANG Quanbing;LIU Yi;LI Kai;ZHENG Haoran;WANG Jing;WANG Qunan(Department of Rehabilitation Medicine,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;The Second Clinical College of Anhui Medical University,Hefei 230601,China;Department of Hygiene Toxicology,School of Public Health,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第二附属医院康复医学科,安徽省合肥市230601 [2]安徽医科大学第二临床医学院,安徽省合肥市230601 [3]安徽医科大学公共卫生学院卫生毒理学教研室,安徽省合肥市230032

出　　处：《中国全科医学》2022年第32期4052-4058,共7页Chinese General Practice

基　　金：安徽省重点研究和开发计划项目(人口健康领域)(201904a07020067);安徽医科大学2022年临床医学学科建设项目(临床与前期共建学科项目)(2022 lcxkEFY010);安徽医科大学2021年临床医学学科建设项目(2021 lcxk031);安徽省2020年高等学校省级质量工程项目(2020jyxm0903)。

摘　　要：背景创伤性伸直型膝关节挛缩在临床上十分常见,绝大部分患者存在步态异常。在临床康复中,对于步态的评估多采用量表及平衡仪进行。动态足底压力测试作为科学、客观的评估方法已广泛应用于下肢疾病的评估。但国内外对于动态足底压力测试在创伤性伸直型膝关节挛缩患者中的应用较少。目的探讨创伤性伸直型膝关节挛缩患者动态足底压力的分布规律,为指导康复评估和步态训练提供数据支持。方法选择2020年12月至2021年12月在安徽医科大学第二附属医院康复医学科接受治疗的创伤性伸直型膝关节挛缩患者35例为研究组,选取同时期志愿参与本研究的步态正常的健康者30例作为对照组。应用ByGait-G6060-5步态分析系统测量仪分别采集两组受试者足底压力参数,对比分析两组受试者步长、步宽、步速、足角、总触地时长、足底各分区〔踇趾(T1区),第二至第五脚趾(T2区),第一跖骨(M1区),第二跖骨(M2区),第三跖骨(M3区),第四跖骨(M4区),第五跖骨(M5区),足底中部(MF区),足后跟内侧(MH区),足后跟外侧(LH区)〕压力占比、足底压力Ad值、足底压力中心在横向(身体左右方向)的最大偏移距离(COP-X偏移)、足底压力中心在纵向(身体前后方向)的最大偏移距离(COP-Y偏移)。结果研究组步长短于对照组,步宽、总触地时长长于对照组,步速慢于对照组,足角高于对照组(P<0.05)。研究组T2区、M4区、M5区足底压力占比高于对照组,MH区、LH区足底压力占比低于对照组(P<0.05)。研究组患侧足底压力Ad值占比低于健侧(P<0.01)。对照组左侧与右侧足底压力Ad值占比比较,差异无统计学意义(P>0.05)。研究组在COP-X方向、COP-Y方向的偏移值均高于对照组(P<0.05)。结论创伤性伸直型膝关节挛缩患者步长短、步宽大、步速慢、足角大、双足总触地时长长,步行时患侧下肢负重较少,且主要以前足和足外侧�Background Traumatic extensor knee contracture is very common in clinic,and most patients have gait abnormalities.In clinical rehabilitation,the assessment of gait is mostly performed using scales and balance instruments.Dynamic plantar pressure test,as a scientific and objective assessment method,has been widely used in the assessment of lower limb diseases.The use of dynamic plantar pressure test in patients with traumatic extensor knee contracture is less common both nationally and internationally.Objective To investigate the distribution pattern of dynamic plantar pressure in patients with traumatic extensor knee contracture,and to provide data support for guiding rehabilitation assessment and gait training.Methods From December 2020 to December 2021,35 patients with traumatic extensor knee contracture who were treated in the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Anhui Medical University were selected as the study group,and 30 healthy individuals with normal gait who volunteered to participate in this study during the same period were selected as the control group.ByGait-G6060-5 gait analysis system measuring instrument was used to collect the plantar pressure parameters of the two groups of subjects.The step length,step width,step speed,foot angle,total touchdown time,the proportion of plantar pressure in each area〔hallux toe(T1 area),second to fifth toe(T2 area),first metatarsal(M1 area),second metatarsal(M2 area),third metatarsal(M3 area),fourth metatarsal(M4 area),fifth metatarsal(M5 area),middle plantar(MF area),medial heel(MH area),lateral heel(LH area)〕,the total plantar pressure Ad value,the maximum deviation distance(COP-X deviation)of plantar pressure center in the lateral(left-right body direction)and the maximum deviation distance(COP-Y deviation)of plantar pressure center in the longitudinal(anterior-posterior body direction)of the two groups were compared and analyzed.Results The step length of the study group was shorter than that of the control group,th

关 键 词：膝关节挛缩 创伤和损伤 动态足底压力 步态 负重 病例对照研究 

分 类 号：R684[医药卫生—骨科学]