韩秀兰,张珊珊,张桂芳,等.慢性足底筋膜炎患者步行时足底压力的动态分布特征研究[J].中华物理医学与康复杂志,2025,47(8):721-726
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| 慢性足底筋膜炎患者步行时足底压力的动态分布特征研究 |
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| DOI：10.3760/cma.j.cn421666-20231213-00994 |
| 中文关键词: 足底筋膜炎 足底压力 分布特征 |
| 英文关键词: Plantar fasciitis Plantar pressure Gait |
| 基金项目:国家自然科学基金（82102677）；广东省中医药局资助课题（20221073）；广东省医学科学技术研究基金项目（A2022096） |
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| 中文摘要: |
| 目的 分析慢性足底筋膜炎（PF）患者步行时足底压力的动态分布特征研究。 方法 募集符合标准的单侧慢性PF患者20例，将其设为PF组；另招募符合标准的健康受试者23例，将其设为正常组。采用足底压力传感器测量2组受试者步行时的足底压力，足印分区包括内侧跟骨（MH）、外侧跟骨（LH)、内侧纵弓(MLA)、外侧纵弓(LLA)、第一跖骨(M1)、Ⅱ-Ⅲ跖骨(M2-3)、Ⅳ-Ⅴ跖骨(M4-5)、第一趾骨(T1)、Ⅱ-Ⅴ趾骨(T2-5)；足底压力参数则包括足底峰值压力(PP)、平均压力(MP)、足底各区域的压力百分比、足底总受力面积(TCA)和足底各区域的受力面积。采用SPSS 20.0版统计学软件对所采集的各项足底动态参数进行统计学分析。 结果 步行时，PF组患足的PP值为（2.41±0.44）kg/cm2，显著低于健足的（3.02±0.63）kg/cm2（P<0.05），且其患足和健足的PP和MP值均显著高于正常组对应足（非利足和利足），差异均有统计学意义（P<0.05）。步行时，PF组健足足底MH、M2-3、M1、MLA、M4-5、T2-5区域的压力百分比与其患足同区域比较，差异均有统计学意义（P<0.05）；且PF组患足足底LH、M4-5、T2-5、M2-3、T1区域的压力百分比与正常组非利足同区域比较，差异均有统计学意义（P<0.05）。PF组健足LH区域的足底压力百分比显著大于正常组利足LH区（P<0.05）。步行时，PF组患足足底T2-5区的受力面积则显著小于其健足T2-5区，差异有统计学意义（P<0.05）；且PF组健足和患足足底的总受力面积均显著小于正常组对应足（利足和非利足），而PF组患足足底T2-5区的受力面积亦显著小于正常组非利足足底T2-5区（P<0.05）。 结论 PF患者步行时的足底压力双足对称性差，压力有向健侧转移和向外侧转移的倾向；与健康受试者比较，PF患者步行时双足的受力面积更小，足底压力却更大。 |
| 英文摘要: |
| Objective To analyze the dynamic plantar pressure distribution of persons with chronic plantar fasciitis (PF). Methods Twenty persons with unilateral, chronic PF were recruited as the PF group, while twenty-three healthy counterparts were recruited as the control group. A foot-pressure measurement system was used to collect data describing the plantar pressure for each subject with or without PF while walking. The pressure data included the load of peak plantar pressure (PP), the mean plantar pressure (MP), the total foot ground contact area (TCA), and the load percentage and the foot ground contact area beneath the medial heel (MH), the lateral heel (LH), the medial longitudinal arch (MLA), the lateral longitudinal arch (LLA), the first metatarsal head (M1), the second to third metatarsal heads (M2-3), the fourth to fifth metatarsal heads (M4-5), the hallux (T1), and toes two to five (T2-5). Results In the PF group, significant differences were observed during walking between the affected and unaffected feet in terms of PP ［(2.41±0.44)kg/cm2 versus (3.02±0.63)kg/cm2］. Both were significantly greater than among the control group. Asymmetry in the load distribution was identified beneath the MH, M2-3, M1, MLA, M4-5 and T2-5 among the chronic PF group. There were also significant differences between the affected foot of the chronic PF group and the non-dominant foot of the control group with regard to the load percentage beneath the LH, M4-5, T2-5, M2-3 and T1. The load percentage under the LH was significantly higher under the unaffected foot of the PF group than under the dominant foot of the control group. In terms of ground contact area, the T2-5 area of the affected foot of the PF group was significantly smaller than that of the unaffected foot, as well as compared to the non-dominant foot of the control group. The TCA of both feet among the PF group was significantly smaller than under the corresponding feet of the control group. Conclusions Patients with chronic plantar fasciitis apply plantar pressure asymmetrically during walking. They tend to shift their weight laterally onto the asymptomatic foot. During walking, those with PF apply higher plantar pressure over a smaller ground contact area. |
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