基于ICF的青年女性“内八字”步态生物力学分析

Biomechanical analysis of in-toeing gait in young females based on ICF

目的应用ICF和生物力学手段评定和分析“内八字”步态下肢肌肉活动和足底压力特征。方法2021年9月至2022年5月,共招募60例青年女性,30例异常步态(步向角<-18°)作为试验组,30例正常步态作为对照组。运用《国际功能、残疾和健康分类》(ICF)对下肢运动功能进行编码,采用无线表面肌电测试仪和鞋垫式足底压力系统测试下肢肌肉表面肌电信号和足底压力。结果试验组胫骨前肌的积分肌电值(iEMG)和肌肉贡献率高于对照组(|t|>2.000,P<0.05),股直肌的iEMG和肌肉贡献率低于对照组(|t|>2.233,P<0.05);第2~5跖骨区、足跟外侧区和全足区域的接触面积(t>2.879,P<0.01),第1跖骨区、中足区和足跟外侧区的压力峰值(t>2.720,P<0.01),第1~5跖骨区和足跟外侧区的峰值压强(t>2.079,P<0.05)以及第1、4跖骨区和足跟外侧区的冲量(t>2.310,P<0.05)高于对照组,在足跟内侧区域的冲量(t=-3.024,P=0.002)低于对照组。结论“内八字”步态者以胫骨前肌和股直肌肌肉活动异常为主;足跟外侧区的接触面积较大,峰值压力、压强和冲量较高;足跟内侧区域的冲量较低。

Objective To evaluate and analyze the characteristics of lower limb muscle activity and plantar pressure in females with the in-toeing gait using International Classification of Functioning,Disability and Health(ICF)and biomechanical methods.Methods A total of 60 young females were recruited from September 2021 to May 2022,out of whom 30 females with in-toeing gait were as experimental group,and 30 females with normal gait were as control group.The motor function of lower extremities was coded by ICF,and the surface EMG signals and plantar pressure characteristics of lower limbs(rectus femoris,biceps femoris,gastrocnemius and tibialis anterior)were measured by wireless surface EMG tester and insole plantar pressure system.Results The integral electromyography(iEMG)and muscle contribution rate of tibialis anterior were higher(|t|>2.000,P<0.05),and the iEMG and muscle contribution rate of rectus femoris were lower(|t|>2.233,P<0.05)in the experimental group than in the control group.The contact area of the 2nd to the 5th metatarsal bone,heel lateral and total foot areas(t>2.879,P<0.01),the peak force of the 1st metatarsal bone,mid foot and heel lateral areas(t>2.720,P<0.01),the peak pressure of the 1st to the 5th metatarsal bone and heel lateral areas(t>2.079,P<0.05),and the impulse of the 1st and the 4th metatarsal bone,and heel lateral areas(t>2.310,P<0.05)were significantly higher,while the impulse of heel medial area was lower(t=-3.024,P=0.002)in the experimental group than in the control group.Conclusion In the process of natural walking,the muscle activity of the in-toeing gait in young female is dominated by tibialis anterior and rectus femoris,the contact area of heel lateral area is larger,the peak pressure,pressure,and impulse are higher,and the impulse of heel medial area is lower.