“理筋束骨”手法调整柔韧性扁平足儿童足踝筋骨功能态的生物力学机制研究

柔韧性扁平足在儿童青少年时期发病广泛，主要表现为足部疼痛、运动功能下降，严重影响儿童的正常运动发育。目前对该类患儿足踝筋骨功能失衡的生物力学机制研究集中于步行状态，尚无对“跑”“跳”复杂运动工况进行的研究。本团队前期研究发现“理筋”及“束骨”手法能有效提高柔韧性扁平足儿童的足踝运动功能。对比该病常见其他非手术干预方法，手法干预优势显著，但其发挥作用的生物力学机制尚不明确。基于前期研究基础，申请人提出“‘理筋束骨’手法通过调整足部骨骼-肌肉复合体关系改善足踝筋骨功能态恢复柔韧性扁平足儿童运动功能”的假说。拟创新应用“下肢-足踝一体化多刚体模型”采集儿童“走-跑-跳”多工况下生物力学数据集，通过逆动力学建模分析，搭建“多运动状态儿童下肢肌-骨生物力学模型”，明确手法改善柔韧性扁平足儿童运动功能的生物力学机制，为手法干预儿童柔韧性扁平足提供科学依据，拓展推拿手法治疗儿童运动发育疾病的新思路。

Flexible flatfoot is widely common in adolescents. The main clinical manifestations are foot pain and reduced motor function, which seriously affects the normal motor development of children. Studies on the biomechanical mechanisms of ankle tendon imbalance in this group of children mainly focus on the walking state, but not on the complex movement such as "running" and "jumping". Our team's previous research has found that the "Lijin" and "Shugu" Tuina are effective in improving motor function of the ankle in children with flexible flatfoot. Manipulative have significant advantages over other non-surgical interventions commonly used for this disorder, but the biomechanical mechanisms are unclear. Based on the previous research, the applicant proposed the hypothesis that "'Lijin & Shugu' Tuina improves the functional state of the ankle tendons and bones by adjusting the relationship between the skeletal-muscular complex of the foot to restore the motor function of children with flexible flatfoot". It is proposed to collect biomechanical data sets of children's multiple conditions such as walking, running and jumping by applying an innovative "integrated lower limb and multiple segments foot model". Through inverse kinetic modelling analysis, a "child lower limb muscle-bone biomechanical model in multiple conditions" will be constructed to clarify the biomechanical mechanisms of manipulation, to improve motor function in children with flexible flatfoot. This study can provide a scientific basis for the intervention of manipulative methods in children with flexible flatfoot and expand new ideas for the treatment of motor developmental disorders in children with Tuina treatments.