髌股关节疼痛患者足底压力评估模型构建  

Development of Plantar Force Assessment Model for Patients with Patellofemoral Pain

作　　者：周文琪[1] 袁正 冉静 许杰 洪桥梅 罗小兵[1] 沈海[1] 王婧鲆 ZHOU Wenqi;YUAN Zheng;RAN Jing;XU Jie;HONG Qiaomei;LUO Xiaobing;SHEN Hai;WANG Jingping(Department of Sport Medicine,Sichuan Orthopedic Hospital,Chengdu 610041,China;College of Sports and Health,Chengdu Sports University,Chengdu 610041,China)

机构地区：[1]四川省骨科医院运动医学科,成都610041 [2]成都体育学院运动与健康学院,成都610041

出　　处：《医用生物力学》2022年第4期748-753,共6页Journal of Medical Biomechanics

基　　金：国家重点研发计划项目(2019YFF0301703);四川省干部保健科研课题(川干研2021-602);成都中医药大学医院项目(YYZX2018007)。

摘　　要：目的构建髌股关节疼痛(patellofemoral pain,PFP)足底压力模型,为该病康复评定提供理论依据。方法采用病例对照研究,共纳入126例PFP患者(PFP组),并根据年龄、性别1∶1匹配126例健康志愿者纳入对照组。以是否发生PFP为因变量,以受试者自选步速下平地行走时足底12个分区峰值压力和峰值压强为自变量,分别构建峰值压力、峰值压强与PFP的条件logistic回归方程,并绘制对应方程的受试者工作特征(receiver operating characteristic,ROC)曲线,计算曲线下面积以分析不同方程对PFP的评估效果。结果构建受试者足底12个分区峰值压力与PFP的条件logistic回归方程,仅足跟外侧区峰值压力进入回归方程;而通过各个分区峰值压强构建的回归方程中则包括足跟内侧区、中足区、第1跖骨区、第2跖骨区4个区域的变量,同时压强方程ROC曲线下面积大于压力方程曲线下面积。结论可使用平地行走中PFP患者足底不同分区峰值压力、压强对PFP进行评估,峰值压强评估效果相对较好。Objective To develop plantar force model of patellofemoral pain(PFP),so as to provide theoretical references for the assessment of PFP rehabilitation.Methods The case-control study was conducted,and a total of 126 patients with PFP and 126 healthy controls matched by gender and age were enrolled in the study.The participants were tested for plantar force and pressure during level walking,and twelve plantar regions were divided and recorded.Whether the participants suffered PFP was analyzed as dependent variable,meanwhile the peak force and peak pressure in 12 plantar regions of participants at selected speed during level walking were analyzed as independent variables.Conditional logistic regression(CLR)equations of peak force and peak pressure with PFP were established,respectively.The receiver-operating characteristic(ROC)curve of the corresponding equations was derived,and the area under ROC curve was calculated to analyzed the validity of different equations on PFP assessment.Results The CLC equation of peak force in 12 plantar regions of the participants with FFP was constructed,and only peak force of lateral heel was in the equation.The CLC equation of peak pressure in each plantar region included medial heel,midfoot,1^(st) and 2^(nd) metatarsals.Meanwhile,the area under ROC curve of the pressure equation was larger than that of the force equation.Conclusions Peak force and pressure at different plantar regions can be used to assess PFP during level walking,and peak pressure is more effective for assessment.

关 键 词：髌股关节疼痛 足底压力 足底压强 条件LOGISTIC回归 受试者工作特征曲线 

分 类 号：R318.01[医药卫生—生物医学工程]