Ankle and subtalar kinematics measured with intracortical pins during the stance phase of walking
Ankle and subtalar kinematics measured with intracortical pins during the stance phase of walking
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DOI：
10.1177/107110070402500514
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发表时间：
2004-05-01
影响因子：
2.7
通讯作者：
Lundberg, A
中科院分区：
文献类型：
--
作者：
Arndt, A;Westblad, P;Lundberg, A
背景：由于距骨外部标志的缺失，使得踝关节和距下关节运动学的描述变得困难。然而，这些关节的异常运动暗示了一系列下肢过度使用损伤的病因。研究方法：在局部麻醉下将皮质内骨针插入胫骨、距骨和跟骨，外部标记簇由视频运动分析系统跟踪。运动学数据收集过程中行走试验在一个平面上的三个主题。步态模式监测比较地面反作用力曲线在站立阶段与无引脚插入。结果：两个关节的螺旋轴方向和组件绕这些轴旋转的结果。踝关节和距下关节螺旋轴方向存在较大的受试者间差异。踝关节和距下关节在整个站立阶段的最大旋转分别为：外翻/内翻，6.3 °和8.3 °;背屈/跖屈，18.7 °和3.7 °;外展/内收，5.0 °和6.1 °。结论：大多数踝关节外翻/内翻发生在距下关节;然而，踝关节组件不能被忽视。距下关节的外展/内收运动范围惊人地高，表明行走过程中的该分量运动并不完全归因于踝关节。未来的研究应包括更多的受试者数量，以呈现更普遍适用的结果。临床相关性：在负重活动过程中距骨的体内运动学知之甚少。这种运动的描述可能有助于临床康复的结构和踝关节假体的设计和插入。
Background: The absence of external landmarks on the talus has rendered the description of ankle and subtalar joint kinematics difficult. Abnormal motion at these joints has, however, been implied in the etiology of an array of lower extremity overuse injuries. Methods: Intracortical pins were inserted under local anesthesia in the tibia, talus, and calcaneus with external marker clusters traced by a video motion analysis system. Kinematic data were collected during walking trials on a flat surface for three subjects. Gait pattern was monitored by comparison of ground reaction force curves during stance phase with and without the pins inserted. Results: Results were presented in terms of helical axis orientation for both joints and the component rotations about these axes. Large intersubject differences were seen in both ankle and subtalar joint helical axis orientation. Maximum rotations over the complete stance phase for the ankle and subtalar joints respectively were: eversion/inversion, 6.3degrees and 8.3degrees; dorsiflexion/plantarflexion, 18.7degrees and 3.7degrees; and abduction/adduction, 5.0degrees and 6.1degrees. Conclusions: The majority of ankle eversion/inversion occurred at the subtalar joint; however, the ankle component cannot be ignored. Abduction/adduction range of motion at the subtalar joint was surprisingly high, indicating that this component motion during walking is not purely attributable to the ankle joint. Future research should include greater subject numbers in order to present more universally applicable results. Clinical Relevance: The in vivo kinematics of the talus during weightbearing activity are poorly understood. The description of this motion may assist in the structuring of clinical rehabilitation and in the design and insertion of ankle joint prostheses.