Background

The aim of this study was to analyse the effect of induced lower limb joint restriction on plantar pressures during gait. Focusing on restricting a single joint, without the effect of other co-morbidities, would provide better understanding as to the resultant plantar loadings during gait, which would be especially beneficial in patients requiring offloading procedures.

Research Question

Does induced lower limb joint restriction affect plantar pressure distribution during gait?

Methods

A prospective, quasi-experimental study was conducted, recruiting ten healthy, adult participants who were instructed to walk barefoot over a Tekscan HR Mat™. This procedure was repeated after separately inducing restriction of the hip, knee and ankle joints. Mean peak plantar pressure (MPP) and pressure-time integral (PTI) data were analysed to compare between unrestricted and restricted data.

Results

Significant plantar pressure changes were observed in the heel and first metatarsal regions. Rearfoot PTIs were increased with restriction of the contralateral hip (left p <0.001) (right p =0.02) and knee joints (left p =0.01) (right p =0.04). Both MPPs (left p =0.01; right p =0.01) and PTIs (left p =0.004; right p =0.03) were increased in the first metatarsal when restricting the hip joint of the same limb. MPP was decreased in the left first metatarsal with induced knee (left p =0.01; right p =0.04) and ankle (left and right p <0.001) joint restriction. Finally, MPP was decreased in the right first metatarsal with knee (left and right p =0.01) and ankle (left p =0.04; right p =0.01) joint restriction.

Significance

Limited joint mobility may have a direct effect on plantar pressure, particularly with restriction in the hip and knee joints, hence careful attention should be given especially in patients with conditions involving plantar loadings. Results in this study also show that PTI changes during gait should be equally evaluated clinically along with peak plantar pressure analysis.

中文翻译：

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步态过程中诱导关节限制对足底压力的影响——一项初步研究

背景

本研究的目的是分析诱导下肢关节限制对步态过程中足底压力的影响。专注于限制单个关节，而没有其他合并症的影响，可以更好地了解步态期间产生的足底负荷，这对于需要卸载程序的患者尤其有益。

研究问题

诱导下肢关节受限会影响步态时足底压力分布吗？

方法

进行了一项前瞻性、准实验性研究，招募了 10 名健康的成年参与者，他们被指示赤脚走在 Tekscan HR Mat™ 上。在分别诱导髋关节、膝关节和踝关节受限后重复该过程。分析平均峰值足底压力 (MPP) 和压力时间积分 (PTI) 数据以比较不受限制和受限制的数据。

结果

在足跟和第一跖骨区域观察到显着的足底压力变化。随着对侧髋关节（左p <0.001）（右p = 0.02）和膝关节（左p = 0.01）（右p =0.04）的限制，后足 PTI 增加。当限制同一肢体的髋关节时，第一跖骨的MPP（左p =0.01；右p =0.01）和 PTI（左p =0.004；右p =0.03）均增加。诱导膝关节（左p = 0.01；右p = 0.04）和踝关节（左右p<0.001) 关节限制。最后，右第一跖骨的 MPP 降低，膝关节（左右p = 0.01）和踝关节（左p = 0.04；右p = 0.01）关节受限。

意义

受限的关节活动度可能对足底压力有直接影响，特别是髋关节和膝关节受限，因此应特别注意足底负重的患者。本研究的结果还表明，步态期间的 PTI 变化应与足底压力峰值分析一起进行临床评估。