Effect of Achilles tendon loading on plantar fascia tension in the standing foot
Effect of Achilles tendon loading on plantar fascia tension in the standing foot
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DOI：
10.1016/j.clinbiomech.2005.09.016
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发表时间：
2006-02-01
影响因子：
1.8
通讯作者：
An, KN
中科院分区：
文献类型：
--
作者：
Cheung, JTM;Zhang, M;An, KN
背景 足底筋膜是人足部主要的足弓支撑结构之一，在负重过程中承受着高张力。据报道，跟腱负荷与足底筋膜张力之间呈正相关。跟腱的过度拉伸和紧绷被认为是足底筋膜炎的危险因素，但其对足底筋膜的生物力学影响尚未得到充分解决。采用结合了几何和材料非线性的人体足部和踝关节三维有限元模型来研究不同跟腱载荷大小下站立脚足底筋膜的载荷响应。当一只脚的总地面反作用力保持在 350 N（相当于一半体重）时，跟腱负荷从 (0-700 N) 增加，导致前脚总力和峰值足底压力普遍增加约 250%。由于跟骨上的跖屈力矩，随着跟腱负荷的增加，压力中心发生侧向和前移，足弓高度降低。根据模拟平衡站立的有限元预测，发现足部总重量 (350 N) 75% 的跟腱力与平衡站立期间测量的受试者压力中心最接近。脚上的重量和跟腱负荷都导致足底筋膜张力增加，后者表现出两倍大的应变效应。解释。跟腱张力的增加伴随着足底筋膜压力的增加。强烈的肌肉收缩和紧绷的跟腱被动拉伸导致的跟腱过度拉伸是足底筋膜过度拉伸的可能机械因素。 (c) 2005 Elsevier Ltd. 保留所有权利。
Background The plantar fascia, which is one of the major arch-supporting structures of the human foot, sustains high tensions during weight-bearing. A positive correlation between Achilles tendon loading and plantar fascia tension has been reported. Excessive stretching and tightness of the Achilles tendon are thought to be the risk factors of plantar fasciitis but their biomechanical effects on the plantar fascia have not been fully addressed.Methods. A three-dimensional finite element model of the human foot and ankle, incorporating geometrical and material nonlinearity, was employed to investigate the loading response of the plantar fascia in the standing foot with different magnitudes of Achilles tendon loading.Findings. With the total ground reaction forces of one foot maintained at 350 N to represent half body weight, an increase in Achilles tendon load from (0-700 N) resulted in a general increase in total force and peak plantar pressure at the forefoot of up to about 250%. There was a lateral and anterior shift of the centre of pressure and a reduction in the arch height with an increasing Achilles tendon load as a result of the plantar flexion moment on the calcaneus. From the finite element predictions of simulated balanced standing, Achilles tendon forces of 75% of the total weight on the foot (350 N) were found to provide the closest match of the measured centre of pressure of the subject during balanced standing. Both the weight on the foot and Achilles tendon loading resulted in an increase in tension of the plantar fascia with the latter showing a two-times larger straining effect.Interpretation. Increasing tension on the Achilles tendon is coupled with an increasing strain on the plantar fascia. Overstretching of the Achilles tendon resulting from intense muscle contraction and passive stretching of tight Achilles tendon are plausible mechanical factors for overstraining of the plantar fascia. (c) 2005 Elsevier Ltd. All rights reserved.