Midfoot and ankle motion during heel rise and gait are related in people with diabetes and peripheral neuropathy.
Midfoot and ankle motion during heel rise and gait are related in people with diabetes and peripheral neuropathy.
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DOI：
10.1016/j.gaitpost.2020.11.013
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发表时间：
2021-03
期刊：
影响因子：
2.4
通讯作者：
Hastings MK
中科院分区：
文献类型：
--
作者：
Jeong HJ;Mueller MJ;Zellers JA;Hastings MK
糖尿病和周围神经病变（DMPN）患者的中足和踝关节运动功能障碍与步态中足畸形和足底压力增加有关。如果在脚跟抬起和步态蹬离期间中足和踝关节运动具有相似的力学机制，则脚跟抬起性能可能是识别步态期间异常中足和踝关节功能的临床可行方法。DMPN患者脚跟抬高期间的中足和踝关节运动是否与步态期间蹬地时的中足和踝关节运动相关？60名患有DMPN的成年人完成了双肢脚跟上升，单肢脚跟上升和行走。使用改良的牛津多节足模型（前足、后足、小腿）分析足跟抬高和步态过程中的中足（前足对后足）和踝关节（后足对小腿）矢状角。皮尔森相关性被用来测试脚跟上升和步态运动学变量之间的关系（n=60）。此外，我们将60名参与者分为两个亚组，根据脚跟最高点时的中足和踝关节位置：中足和踝关节背屈（背屈; n=23）和中足和踝关节跖屈（跖屈; n=20）。检查了单肢足跟抬高时中足和踝关节运动的运动轨迹以及亚组的步态。峰值双肢脚跟上升和步态中足和踝关节角度显着相关（r=0.49和r=0.40，分别）。峰值单肢脚跟上升和步态中足和踝关节的角度显着相关（r=0.63和r=0.54，分别）。与跖屈亚组相比，背屈亚组（通过足跟抬高性能识别）在步态期间显示出更大的中足和踝关节背屈（亚组之间的平均差异：中足3°，踝关节3°）。患有DMPN的人在脚跟上升期间不能跖屈中足和踝关节，在步态期间跖屈中足和踝关节有困难。利用脚跟上升任务可能有助于识别与DMPN患者步态相关的中足和踝关节功能障碍。
Midfoot and ankle movement dysfunction in people with diabetes mellitus and peripheral neuropathy (DMPN) is associated with midfoot deformity and increased plantar pressures during gait. If midfoot and ankle motion during heel rise and push-off of gait have similar mechanics, heel rise performance could be a clinically feasible way to identify abnormal midfoot and ankle function during gait. Is midfoot and ankle joint motion during a heel rise associated with midfoot and ankle motion at push-off during gait in people with DMPN? Sixty adults with DMPN completed double-limb heel rise, single-limb heel rise, and walking. A modified Oxford multi-segment foot model (forefoot, hindfoot, shank) was used to analyze midfoot (forefoot on hindfoot) and ankle (hindfoot on shank) sagittal angle during heel rise and gait. Pearson correlation was used to test the relationship between heel rise and gait kinematic variables (n=60). Additionally, we classified 60 participants into two subgroups based on midfoot and ankle position at peak heel rise: midfoot and ankle dorsiflexed (dorsiflexed; n=23) and midfoot and ankle plantarflexed (plantarflexed; n=20). Movement trajectories of midfoot and ankle motion during single-limb heel rise and gait of the subgroups were examined. Peak double-limb heel rise and gait midfoot and ankle angles were significantly correlated (r=0.49 and r=0.40, respectively). Peak single-limb heel rise and gait midfoot and ankle angles were significantly correlated (r=0.63 and r=0.54, respectively). The dorsiflexed subgroup, identified by heel rise performance showed greater midfoot and ankle dorsiflexion during gait compared to the plantarflexed subgroup (mean difference between subgroups: midfoot 3°, ankle 3°). People with DMPN who fail to plantarflex the midfoot and ankle during heel rise have difficulty plantarflexing the midfoot and ankle during gait. Utilizing a heel rise task may help identify midfoot and ankle dysfunction associated with gait in people with DMPN.
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