Deep posterior compartment strength and foot kinematics in subjects with stage II posterior tibial tendon dysfunction.
Deep posterior compartment strength and foot kinematics in subjects with stage II posterior tibial tendon dysfunction.
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DOI：
10.3113/fai.2010.0320
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发表时间：
2010-04
影响因子：
2.7
通讯作者：
Houck JR
中科院分区：
文献类型：
--
作者：
Neville C;Flemister AS;Houck JR
II 期胫骨后肌腱功能障碍 (PTTD) 受试者中已有胫骨后肌无力的记录，但无力对足部结构的影响仍不清楚。力量和扁平足运动学之间的关联可以指导治疗，例如使用针对胫骨后肌的强化计划。 30 名 II 期 PTTD 受试者（年龄；58.1 ± 10.5 岁，BMI 30.6 ± 5.4）和 15 名匹配对照者（年龄；56.5 ± 7.7 岁，BMI 30.6 ± 3.6）自愿参加本研究。从每个受试者的双腿测量深部后室强度，并使用强度比来比较每个受试者受累侧与未受累侧。预先定义 20% 的缺陷来定义两组患有 PTTD 的受试者。每组的强度比取平均值；对照为 1.06 ± 0.1（范围 0.87 至 1.36），PTTD 强组为 1.06 ± 0.1（范围 0.89 至 1.25），PTTD 弱组为 0.64 ± 0.2（范围 0.42 至 0.76）。在站立的四个阶段中，使用对每个运动学变量重复的双向混合效应方差分析模型来比较三组之间平足的运动学测量。与对照组相比，患有 PTTD 的受试者（无论哪组）都表现出明显更大的后足外翻。与强壮的 PTTD 受试者相比，虚弱的 PTTD 受试者表现出更大的后足外翻。对于前足外展和 MLA 角度，各组之间的差异取决于站立阶段，在站立前摆动阶段观察到各组之间存在显着差异。力量与步行过程中观察到的平足畸形程度相关，然而，没有力量缺陷也可能发生平足畸形。
Tibialis posterior muscle weakness has been documented in subjects with Stage II posterior tibial tendon dysfunction (PTTD) but the effect of weakness on foot structure remains unclear. The association between strength and flatfoot kinematics may guide treatment such as the use of strengthening programs targeting the tibialis posterior muscle. Thirty Stage II PTTD subjects (age; 58.1 ± 10.5 years, BMI 30.6 ± 5.4) and 15 matched controls (age; 56.5 ± 7.7 years, BMI 30.6 ± 3.6) volunteered for this study. Deep Posterior Compartment strength was measured from both legs of each subject and the strength ratio was used to compare each subject’s involved side to their uninvolved side. A 20% deficit was defined, a priori, to define two groups of subjects with PTTD. The strength ratio for each group averaged; 1.06 ± 0.1 (range 0.87 to 1.36) for controls, 1.06 ± 0.1 (range, 0.89 to 1.25), for the PTTD strong group, and 0.64 ± 0.2 (range 0.42 to 0.76) for the PTTD weak group. Across four phases of stance, kinematic measures of flatfoot were compared between the three groups using a two-way mixed effect ANOVA model repeated for each kinematic variable. Subjects with PTTD regardless of group demonstrated significantly greater hindfoot eversion compared to controls. Subjects with PTTD who were weak demonstrated greater hindfoot eversion compared to subjects with PTTD who were strong. For forefoot abduction and MLA angles the differences between groups depended on the phase of stance with significant differences between each group observed at the pre-swing phase of stance. Strength was associated with the degree of flatfoot deformity observed during walking, however, flatfoot deformity may also occur without strength deficits.