Foot and Ankle Joint Biomechanical Adaptations to an Unpredictable Coronally Uneven Surface.
Foot and Ankle Joint Biomechanical Adaptations to an Unpredictable Coronally Uneven Surface.
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足和踝关节生物力学对不可预测的冠状不平坦表面的适应。
DOI：
10.1115/1.4037563
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Klute,GlennK
中科院分区：
文献类型：
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作者：
Segal,AvaD;Yeates,KyleH;Neptune,RichardR;Klute,GlennK
冠状凹凸不平的地形是日常行走中常见但具有挑战性的特征，使个人面临更大的跌倒风险。脚踝复合体可能会适应于在不平坦的地形上改善平衡，这一恢复策略对患有足踝病变的患者可能更具挑战性。多节段足部模型(MSFM)被用来研究脚和踝关节在视觉模糊的、冠状不平坦的表面上行走时的生物力学适应性。当10名参与者走在一条仪表式人行道上时，运动学、运动学和鞋内压力数据被收集起来，其中表面在冠状平面上随机放置±15 °或0 °。冠状凹凸不平的表面改变了后足-胫骨的负荷，早期站立时比晚期时更接近表面。尽管体表构型较小，但在站立早期和晚期，前足-后足关节的负荷发生了明显的变化。在两个不平坦的表面上，后足-胫骨相对接触处的力量(@OHC)产生并增加，而前脚-后足力量被吸收，并在表面上保持一致。外翻面上的后足-胫骨关节和内翻面上的前足-后足关节的推出力增加。在两个不平坦的表面上都会产生跨越接缝的净功，而在平坦的地形上则会被吸收。不平坦表面上的部分脱钩和关节特有的生物力学适应表明，多关节干预措施，如假体装置和关节置换，可能会改善在冠状不平地形上行动不便的人的步行能力。
Coronally uneven terrain, a common yet challenging feature encountered in daily ambulation, exposes individuals to an increased risk of falling. The foot-ankle complex may adapt to improve balance on uneven terrains, a recovery strategy which may be more challenging in patients with foot-ankle pathologies. A multisegment foot model (MSFM) was used to study the biomechanical adaptations of the foot and ankle joints during a step on a visually obscured, coronally uneven surface. Kinematic, kinetic and in-shoe pressure data were collected as ten participants walked on an instrumented walkway with a surface randomly positioned ±15 deg or 0 deg in the coronal plane. Coronally uneven surfaces altered hindfoot–tibia loading, with more conformation to the surface in early than late stance. Distinct loading changes occurred for the forefoot–hindfoot joint in early and late stance, despite smaller surface conformations. Hindfoot–tibia power at opposite heel contact (@OHC) was generated and increased on both uneven surfaces, whereas forefoot–hindfoot power was absorbed and remained consistent across surfaces. Push-off work increased for the hindfoot–tibia joint on the everted surface and for the forefoot–hindfoot joint on the inverted surface. Net work across joints was generated for both uneven surfaces, while absorbed on flat terrain. The partial decoupling and joint-specific biomechanical adaptations on uneven surfaces suggest that multi-articulating interventions such as prosthetic devices and arthroplasty may improve ambulation for mobility-impaired individuals on coronally uneven terrain.