目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组...目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组男2例,女8例,平均年龄(46.7±6.5)岁,体质指数(26.7±2.8)kg/m2;脉冲超声波加牵伸组男4例,女6例,平均年龄(45.8±6.1)岁,体质指数(26.4±3.4)kg/m2;超声透入加牵伸组男3例,女7例,平均年龄(48.4±8.0)岁,体质指数(25.4±3.0)kg/m2。超声透入加牵伸和脉冲超声波加牵伸组的超声治疗每日10min,每周治疗5次,共4周,其中超声透入加牵伸组耦合剂使用双氯芬酸二乙胺(扶他林)。另外,所有患者进行小腿后群肌、跟腱及跖筋膜的牵伸训练。在治疗前、治疗后即刻及治疗3个月后,以视觉类比标度(visual analog scale,VAS)评价晨起足跟痛,并抽取足部功能指数量表(foot function index,FFI)中的行动障碍子量表评价患足功能状态。结果:治疗前3组患者资料和足跟痛起始状态组间无明显差异。晨痛及行动障碍的改善:治疗1个月时超声透入加牵伸组改善较单纯牵伸组明显(P<0.05),3个月时3组差异无统计学意义(P>0.05)。而组内比较显示3组晨痛及行动障碍在治疗前后的3个时间点均得到有效改善(P<0.05)。结论:单纯牵伸训练以及联合超声透入或脉冲超声波对治疗跖筋膜炎的晨痛和功能障碍均有效,而联合超声透入治疗效果最佳。展开更多
It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of ou...It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.展开更多
Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients, and plantar fasciitis is the main reason for pain. When systematic conservative treatments fail to alleviate...Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients, and plantar fasciitis is the main reason for pain. When systematic conservative treatments fail to alleviate these conditions, it requires surgical intervention, mainly plantar fascia release surgery, which used to be an open heel release surgery. This study aimed to investigate whether minimally invasive treatment of the KobyGard system is more safe and effective for plantar fasciitis. Methods From May 2009 to May 2012, a total of nine patients, three males and six females with plantar fasciitis, were treated in the Peking University People＇s Hospital with minimally invasive instruments, the KobyGard system, for the release of plantar fascia. Three patients, experiencing bilateral calcaneodynia, underwent bilateral surgery. One patient had bilateral calcaneodynia with enthesiopathy of Achilles tendon, and underwent Achilles tendon surgery. Preoperative and postoperative Visual Analogue Scale （VAS）, American Orthopaedic Foot and Ankle Society （AOFAS） ankle and hindfoot scores, Roles and Maudsley scores and SF-36 questionnaires were evaluated. Results The nine patients were successfully followed up. The average postoperative follow-up time was 13.2 months and it varied from 2.0 months to 21.0 months. Pre- and postoperative average scores of VAS was 9.3 and 1.9 （P 〈0.001）, respectively. Pre- and postoperative average scores of AOFAS hind foot was 36.0 and 82.0 （P 〈0.001）, respectively. There was also a statistically significant amelioration in SF-36 scores and the Roles and Maudlesy scores. Eight patients were satisfied with the surgery outcome. Conclusion Minimally invasive surgery treatment of the KobyGard system for plantar fasciitis has the advantages of shorter operation time, ease of operation, and similar satisfaction rates with open surgery, but with smaller surgical incision.展开更多
In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both ...In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.展开更多
The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury(SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can ...The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury(SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University(approval No. 2015 PS54 J) on August 13, 2015. This trial was registered in the ISRCTN Registry(ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.展开更多
Background:Balance impairment is one of the strongest risk factors for falls.Proprioception,cutaneous sensitivity,and muscle strength are 3 important contributors to balance control in older adults.The relationship th...Background:Balance impairment is one of the strongest risk factors for falls.Proprioception,cutaneous sensitivity,and muscle strength are 3 important contributors to balance control in older adults.The relationship that dynamic and static balance control has to proprioception,cutaneous sensitivity,and muscle strength is still unclear.This study was performed to investigate the relationship these contributors have to dynamic and static balance control.Methods:A total of 164 older adults(female=89,left dominant=15,age:73.5±7.8 years,height:161.6±7.1 cm,weight:63.7±8.9 kg,mean±SD)participated in this study.It tested the proprioception of their knee flexion/extension and ankle dorsi/plantarflexion,along with cutaneous sensitivity at the great toe,first and fifth metatarsals,arch,and heel,and the muscle strength of their ankle dorsi/plantarflexion and hip abduction.The Berg Balance Scale(BBS)and the root mean square(RMS)of the center of pressure(CoP)were collected as indications of dynamic and static balance control.A partial correlation was used to determine the relationship between the measured outcomes variables(BBS and CoPRMS)and the proprioception,cutaneous sensitivity,and muscle strength variables.Results:Proprioception of ankle plantarflexion(r=-0.306,p=0.002)and dorsiflexion(r=-0.217,p=0.030),and muscle strength of ankle plantarflexion(r=0.275,p=0.004),dorsiflexion(r=0.369,p<0.001),and hip abduction(r=0.342,p<0.001)were weakly to moderately correlated with BBS.Proprioception of ankle dorsiflexion(r=0.218,p=0.020)and cutaneous sensitivity at the great toe(r=0.231,p=0.041)and arch(r=0.285,p=0.002)were weakly correlated with CoP-RMS in the anteroposterior direction.Proprioception of ankle dorsiflexion(r=0.220,p=0.035),knee flexion(r=0.308,p=0.001)and extension(r=0.193,p=0.040),and cutaneous sensitivity at the arch(r=0.206,p=0.028)were weakly to moderately correlated with CoP-RMS in the mediolateral direction.Conclusion:There is a weak-to-moderate relationship between proprioception and dynamic and static bala展开更多
文摘目的:评价牵伸训练联合双氯芬酸二乙胺超声透入以及牵伸训练联合脉冲超声波对跖筋膜炎的治疗效果,并比较其疗效。方法:自2009年6月至2012年3月治疗跖筋膜炎30例,分为3组:超声透入加牵伸组,脉冲超声波加牵伸组,单纯牵伸组,各10例。牵伸组男2例,女8例,平均年龄(46.7±6.5)岁,体质指数(26.7±2.8)kg/m2;脉冲超声波加牵伸组男4例,女6例,平均年龄(45.8±6.1)岁,体质指数(26.4±3.4)kg/m2;超声透入加牵伸组男3例,女7例,平均年龄(48.4±8.0)岁,体质指数(25.4±3.0)kg/m2。超声透入加牵伸和脉冲超声波加牵伸组的超声治疗每日10min,每周治疗5次,共4周,其中超声透入加牵伸组耦合剂使用双氯芬酸二乙胺(扶他林)。另外,所有患者进行小腿后群肌、跟腱及跖筋膜的牵伸训练。在治疗前、治疗后即刻及治疗3个月后,以视觉类比标度(visual analog scale,VAS)评价晨起足跟痛,并抽取足部功能指数量表(foot function index,FFI)中的行动障碍子量表评价患足功能状态。结果:治疗前3组患者资料和足跟痛起始状态组间无明显差异。晨痛及行动障碍的改善:治疗1个月时超声透入加牵伸组改善较单纯牵伸组明显(P<0.05),3个月时3组差异无统计学意义(P>0.05)。而组内比较显示3组晨痛及行动障碍在治疗前后的3个时间点均得到有效改善(P<0.05)。结论:单纯牵伸训练以及联合超声透入或脉冲超声波对治疗跖筋膜炎的晨痛和功能障碍均有效,而联合超声透入治疗效果最佳。
文摘It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.
文摘Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients, and plantar fasciitis is the main reason for pain. When systematic conservative treatments fail to alleviate these conditions, it requires surgical intervention, mainly plantar fascia release surgery, which used to be an open heel release surgery. This study aimed to investigate whether minimally invasive treatment of the KobyGard system is more safe and effective for plantar fasciitis. Methods From May 2009 to May 2012, a total of nine patients, three males and six females with plantar fasciitis, were treated in the Peking University People＇s Hospital with minimally invasive instruments, the KobyGard system, for the release of plantar fascia. Three patients, experiencing bilateral calcaneodynia, underwent bilateral surgery. One patient had bilateral calcaneodynia with enthesiopathy of Achilles tendon, and underwent Achilles tendon surgery. Preoperative and postoperative Visual Analogue Scale （VAS）, American Orthopaedic Foot and Ankle Society （AOFAS） ankle and hindfoot scores, Roles and Maudsley scores and SF-36 questionnaires were evaluated. Results The nine patients were successfully followed up. The average postoperative follow-up time was 13.2 months and it varied from 2.0 months to 21.0 months. Pre- and postoperative average scores of VAS was 9.3 and 1.9 （P 〈0.001）, respectively. Pre- and postoperative average scores of AOFAS hind foot was 36.0 and 82.0 （P 〈0.001）, respectively. There was also a statistically significant amelioration in SF-36 scores and the Roles and Maudlesy scores. Eight patients were satisfied with the surgery outcome. Conclusion Minimally invasive surgery treatment of the KobyGard system for plantar fasciitis has the advantages of shorter operation time, ease of operation, and similar satisfaction rates with open surgery, but with smaller surgical incision.
基金supported by the Research Grant Council of Hong Kong (PolyU5317/05E, PolyU5331/07E, PolyU5352/08E)
文摘In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.
基金supported by the New Technique Project of Shengjing Hospital of China Medical University,China,No.2015-117(to XNY)
文摘The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury(SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University(approval No. 2015 PS54 J) on August 13, 2015. This trial was registered in the ISRCTN Registry(ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.
基金funded by Shandong Province Youth Innovative Talent Induction Program(grant number 2019-183)the National Key R&D Program of China(2018YFC2000600).
文摘Background:Balance impairment is one of the strongest risk factors for falls.Proprioception,cutaneous sensitivity,and muscle strength are 3 important contributors to balance control in older adults.The relationship that dynamic and static balance control has to proprioception,cutaneous sensitivity,and muscle strength is still unclear.This study was performed to investigate the relationship these contributors have to dynamic and static balance control.Methods:A total of 164 older adults(female=89,left dominant=15,age:73.5±7.8 years,height:161.6±7.1 cm,weight:63.7±8.9 kg,mean±SD)participated in this study.It tested the proprioception of their knee flexion/extension and ankle dorsi/plantarflexion,along with cutaneous sensitivity at the great toe,first and fifth metatarsals,arch,and heel,and the muscle strength of their ankle dorsi/plantarflexion and hip abduction.The Berg Balance Scale(BBS)and the root mean square(RMS)of the center of pressure(CoP)were collected as indications of dynamic and static balance control.A partial correlation was used to determine the relationship between the measured outcomes variables(BBS and CoPRMS)and the proprioception,cutaneous sensitivity,and muscle strength variables.Results:Proprioception of ankle plantarflexion(r=-0.306,p=0.002)and dorsiflexion(r=-0.217,p=0.030),and muscle strength of ankle plantarflexion(r=0.275,p=0.004),dorsiflexion(r=0.369,p<0.001),and hip abduction(r=0.342,p<0.001)were weakly to moderately correlated with BBS.Proprioception of ankle dorsiflexion(r=0.218,p=0.020)and cutaneous sensitivity at the great toe(r=0.231,p=0.041)and arch(r=0.285,p=0.002)were weakly correlated with CoP-RMS in the anteroposterior direction.Proprioception of ankle dorsiflexion(r=0.220,p=0.035),knee flexion(r=0.308,p=0.001)and extension(r=0.193,p=0.040),and cutaneous sensitivity at the arch(r=0.206,p=0.028)were weakly to moderately correlated with CoP-RMS in the mediolateral direction.Conclusion:There is a weak-to-moderate relationship between proprioception and dynamic and static bala
