基于ICF的青年女性“内八字”步态生物力学分析

doi:10.3969/j.issn.1006-9771.2022.12.011

Abstract

Abstract:

Objective To evaluate and analyze the characteristics of lower limb muscle activity and plantar pressure in females with the in-toeing gait using International Classification of Functioning, Disability and Health (ICF) and biomechanical methods.

Methods A total of 60 young females were recruited from September 2021 to May 2022, out of whom 30 females with in-toeing gait were as experimental group, and 30 females with normal gait were as control group. The motor function of lower extremities was coded by ICF, and the surface EMG signals and plantar pressure characteristics of lower limbs (rectus femoris, biceps femoris, gastrocnemius and tibialis anterior) were measured by wireless surface EMG tester and insole plantar pressure system.

Results The integral electromyography (iEMG) and muscle contribution rate of tibialis anterior were higher (|t| > 2.000, P < 0.05), and the iEMG and muscle contribution rate of rectus femoris were lower (|t| > 2.233, P < 0.05) in the experimental group than in the control group. The contact area of the 2nd to the 5th metatarsal bone, heel lateral and total foot areas (t> 2.879, P < 0.01), the peak force of the 1st metatarsal bone, mid foot and heel lateral areas (t > 2.720, P < 0.01), the peak pressure of the 1st to the 5th metatarsal bone and heel lateral areas (t > 2.079, P < 0.05), and the impulse of the 1st and the 4th metatarsal bone, and heel lateral areas (t > 2.310, P < 0.05) were significantly higher, while the impulse of heel medial area was lower (t = -3.024, P = 0.002) in the experimental group than in the control group.

Conclusion In the process of natural walking, the muscle activity of the in-toeing gait in young female is dominated by tibialis anterior and rectus femoris, the contact area of heel lateral area is larger, the peak pressure, pressure, and impulse are higher, and the impulse of heel medial area is lower.

Key words: in-toeing gait, surface electromyography, plantar pressure, International Classification of Functioning, Disability and Health

CLC Number:

HUANG Zhaoxin,ZHANG Yi,CUI Chenxi,ZHU Xiaojing,XIAO Xiaofei. Biomechanical analysis of in-toeing gait in young females based on ICF[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(12): 1459-1465.

Figures/Tables 7

References 42

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测量工具	内容	编码	类目名称	编码	类目名称	编码	类目名称
表面肌电系统	10 m步态行道，行走3次	b730	肌肉力量功能	b7304	四肢肌肉力量	b73041	肌肉iEMG
表面肌电系统		b730	肌肉力量功能	b7304	四肢肌肉力量	b73042	肌肉贡献率
鞋垫式足底压力系统		b770	步态功能	b7701	足底压力状态	b77011	足底接触面积
						b77012	足底峰值压力
						b77013	足底峰值压强
						b77014	足底冲量

组别	n	胫骨前肌	腓肠肌	股直肌	股二头肌
对照组	30	22.42±8.44	17.54±6.04	29.19±6.50	40.16±80.78
试验组	30	33.86±11.42	28.37±9.97	18.21±4.44	27.91±30.54
t值		3.219	3.679	-4.355	-0.054
P值		0.001	< 0.001	< 0.001	0.957

组别	n	胫骨前肌	腓肠肌	股直肌	股二头肌
对照组	30	26.46±14.71	20.92±11.69	25.33±14.79	27.14±17.18
试验组	30	37.13±15.19	22.59±9.77	17.53±12.75	21.54±12.81
t值		-2.000	-0.803	2.233	1.200
P值		0.046	0.435	0.025	0.281

分区	对照组	试验组	t值	P值
第1趾骨区	3.71±1.73	3.84±1.46	0.635	0.551
第2趾骨区	1.74±1.01	1.61±0.86	-0.607	0.551
第3趾骨区	1.29±0.75	0.96±0.69	-0.848	0.396
第4、5趾骨区	0.31±0.35	0.54±0.70	0.433	0.665
第1跖骨区	6.47±2.06	6.41±2.69	-0.144	0.887
第2跖骨区	4.95±0.48	6.21±0.91	3.640	< 0.001
第3跖骨区	5.80±0.44	7.19±0.60	3.985	< 0.001
第4跖骨区	6.26±0.38	7.59±0.96	3.004	0.002
第5跖骨区	5.22±1.21	8.00±1.20	4.042	< 0.001
中足区	8.67±5.98	10.24±6.18	0.716	0.474
足跟内侧区	11.90±3.31	12.69±2.26	0.453	0.654
足跟外侧区	10.00±1.27	13.89±1.41	2.882	0.002
全足	61.93± 9.73	71.18±7.27	2.879	0.003

分区	对照组	试验组	t值	P值
第1趾骨区	9.28±6.99	9.79±10.37	0.780	0.443
第2趾骨区	2.58±2.45	2.48±3.23	-0.462	0.671
第3趾骨区	1.55±0.50	1.15±1.02	-1.249	0.218
第4、5趾骨区	0.23±0.33	0.27±0.52	0.162	0.912
第1跖骨区	7.23±4.02	16.65±3.90	4.043	< 0.001
第2跖骨区	8.58±1.53	7.68±4.06	-1.589	0.114
第3跖骨区	13.62±3.92	12.71±4.05	-0.578	0.590
第4跖骨区	11.13±4.41	14.27±5.51	1.819	0.068
第5跖骨区	6.68±3.65	13.01±6.13	1.570	0.116
中足区	5.02±4.44	13.69±9.20	2.720	0.005
足跟内侧区	42.50±17.14	34.53±9.06	-1.250	0.218
足跟外侧区	27.48±6.32	42.08±3.65	2.882	0.002
全足	111.07±6.14	130.94±32.28	1.589	0.114

Biomechanical analysis of in-toeing gait in young females based on ICF

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分区	对照组	试验组	t值	P值
第1趾骨区	310.08±275.33	316.83±283.90	0.289	0.799
第2趾骨区	137.92±97.21	107.67±78.37	-0.838	0.410
第3趾骨区	102.70±24.65	91.30±61.95	-1.209	0.247
第4、5趾骨区	38.30±38.70	28.70±33.67	-0.713	0.529
第1跖骨区	123.50±51.93	220.50±86.99	4.044	< 0.001
第2跖骨区	108.33±30.45	164.92±31.00	3.205	0.001
第3跖骨区	179.67±46.99	274.83±47.72	3.495	< 0.001
第4跖骨区	142.67±35.45	274.92±75.41	4.042	< 0.001
第5跖骨区	103.50±30.34	180.33±73.96	2.079	0.039
中足区	84.70±34.45	110.50±66.47	0.681	0.529
足跟内侧区	561.00±287.12	343.40±136.06	-1.777	0.075
足跟外侧区	376.33±47.45	536.33±28.46	2.882	0.002
全足	589.42±280.84	532.92±215.10	-0.347	0.755

分区	对照组	试验组	t值	P值
第1趾骨区	25.6±29.77	41.60±28.01	1.762	0.078
第2趾骨区	18.52±19.35	41.60±28.01	0.641	0.589
第3趾骨区	21.8±14.69	32.19±25.04	1.058	0.315
第4、5趾骨区	8.47±9.59	14.80±21.71	0.154	0.912
第1跖骨区	23.82±12.11	47.72±21.87	2.714	0.006
第2跖骨区	34.90±13.47	46.26±16.86	1.386	0.178
第3跖骨区	48.37±18.08	83.51±30.50	1.762	0.078
第4跖骨区	45.01±22.82	85.88±35.08	2.714	0.006
第5跖骨区	29.78±15.38	58.55±27.33	0.578	0.590
中足区	20.93±10.04	23.89±11.60	0.378	0.739
足跟内侧区	118.94±20.25	85.23±45.94	-3.024	0.002
足跟外侧区	70.42±14.65	81.22±18.93	2.310	0.020
全足	72.05±11.99	75.98±8.29	0.404	0.713

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