长期穿高跟鞋对女性足底构筑及压力的影响

Effects of Long-term Wearing High Heels on Women’s Plantar Architecture and Pressure

着高跟鞋进行日常活动影响足部肌-骨系统的结构和功能。为探讨着高跟鞋站立、行走对足底软组织构筑及刚度、足底压力、足型等的远期影响,选取19名10年以上穿高跟鞋习惯的女性为实验组,20名无穿高跟鞋习惯的女性作对照。以超声诊断系统测试足底软组织厚度、横截面积、剪切波速度;SENSOR MEDICA压力测试系统测试足底压力;足印法采集足印。组间差异采用独立样本t检验。实验组拇展肌和拇短屈肌厚度、剪切波速度、横截面积明显小于对照组;趾短屈肌厚度、横截面积、前/内侧及后足压力、第1跖骨接触面积、拇外翻角、足跟角明显大于对照组。长期着高跟鞋站立、行走削弱拇趾外展和跖屈,加重前足旋前,增加内侧纵弓压力。使趾短屈肌肥大,增加后足压力。建议穿高跟鞋者着重训练拇趾外展、跖屈功能,同时加强趾屈肌向心收缩及足旋后锻炼。

Structure and function of foot musculoskeletal system could be affected by wearing high-heeled shoes for daily activities.This work explored the effects of long-term wearing high-heeled shoes on the plantar soft tissues architecture and stiffness,plantar pressure,and foot morphology in walking or standing.Nineteen women with more than 10-year experience in wearing high-heeled shoes were selected as the experimental group,while twenty women without high heel wearing experience were chosen as the control group.The ultrasonic diagnostic system was used to test their plantar soft tissues’thickness,cross-sectional area,and shear wave velocity;the SENSOR MEDICA pressure test system was applied to record their plantar pressure;the footprint method was adopted to collect their footprint data.The differences between groups were analyzed by using the independent sample t test.It was found that the thickness,shear wave velocity and cross-sectional area of abductor hallucis and flexor hallucis brevis in the experimental group were significantly smaller than those in the control group.Compared to the control group,the experimental group possessed the higher thickness and cross-sectional area of flexor digitorum brevis,fore/medial and rear foot pressure,contact area of first metatarsal bone,hallux valgus angle and heel angle.The long-term standing and walking with high-heeled shoes could weaken the abduction and metatarsal flexion of hallux,aggravate forefoot pronation,increase the pressure of the medial longitudinal arch,result in the muscle fiber of flexor digitorum brevis hypertrophy,and increase the plantar pressure in rearfoot.It is suggested that the wearers of high-heeled shoes should focus on training hallux abduction and plantar flexion,as well as strengthening the exercises of centripetal contraction of the flexor toe muscles and foot supination.