不同高度负跟鞋对健康成人腰腹肌和下肢肌活动的影响

Effects of negative heel shoes of different heights on the activity of psoas and abdominal muscles and lower limb muscles in healthy adults

目的:探讨不同高度负跟鞋对健康成人腰腹肌和下肢肌活动的影响。方法:选取45名健康成人作为受试者,男15名、女30名,年龄(34.87±12.79)岁,身高(167.93±7.15)cm,体质量(65.87±10.82)kg。采用BTS FreeEMG300无线表面肌电系统测定受试者依次穿5种不同高度的负跟鞋(平底鞋、0.5 cm负跟鞋、1 cm负跟鞋、1.5 cm负跟鞋、2 cm负跟鞋)自然匀速直线行走7个步行周期时,双侧腹直肌、腰椎旁肌、胫骨前肌及腓肠肌内侧头的表面肌电信号均方根值(root mean square,RMS)。结果:①腹直肌。受试者穿同一高度负跟鞋行走时,双侧腹直肌表面肌电信号RMS比较,差异均无统计学意义[平底鞋:(15.80,13.59)μV,(17.81,11.70)μV,Z=-5.150,P=0.606;0.5 cm负跟鞋:(16.58,11.77)μV,(17.38,10.77)μV,Z=-0.125,P=0.901;1 cm负跟鞋:(16.33,11.62)μV,(17.25,12.12)μV,Z=-5.190,P=0.604;1.5 cm负跟鞋:(17.50,11.51)μV,(18.09,12.47)μV,Z=-0.023,P=0.981;2 cm负跟鞋:(16.80,11.41)μV,(17.64,10.86)μV,Z=-0.164,P=0.870];受试者穿不同高度负跟鞋行走时,同侧腹直肌表面肌电信号RMS比较,差异均无统计学意义(左侧:χ^(2)=9.191,P=0.056;右侧:χ^(2)=8.645,P=0.071)。②腰椎旁肌。受试者穿同一高度负跟鞋行走时,双侧腰椎旁肌表面肌电信号RMS比较,差异均无统计学意义[平底鞋:(5.43,5.46)μV,(5.65,3.45)μV,Z=-0.412,P=0.681;0.5 cm负跟鞋:(6.04,5.25)μV,(6.53,3.54)μV,Z=-0.198,P=0.843;1 cm负跟鞋:(6.10,5.60)μV,(6.00,4.21)μV,Z=-0.149,P=0.881;1.5 cm负跟鞋:(5.85,5.82)μV,(5.83,4.20)μV,Z=-0.222,P=0.824;2 cm负跟鞋:(6.60,5.15)μV,(5.73,4.41)μV,Z=-0.052,P=0.958];受试者穿不同高度负跟鞋行走时,同侧腰椎旁肌表面肌电信号RMS比较,差异均无统计学意义(左侧:χ^(2)=4.996,P=0.288;右侧:χ^(2)=9.156,P=0.057)。③胫骨前肌。受试者穿同一高度负跟鞋行走时,双侧胫骨前肌表面肌电信号RMS比较,差异均无统计学意义[平底鞋:(51.27,39.27)μV,(49.65,48.12)μV,Z=-0.399,P=0.690;0.5 cm负跟鞋:(51.92,42.07)μV,(54.11,46.61)μV,Z=-0.101,P=0.920;1 cm负跟鞋:(51.46,39.79)μV,(58.69,33.93)μV,Z=-0.488,P=0.625;1.5 cm负跟鞋:(58.53,29.36)μV,(49.16,47.71)μV,Z=-0.480,P=0.631;2 cm负跟鞋:(56.26,41.17)μV,(53.54,45.56)μV,Z=-0.246,P=0.806]。受试者穿不同高度负跟鞋行走时,右侧胫骨前肌表面肌电信号RMS的差异无统计学意义(χ^(2)=5.831,P=0.212)。受试者穿平底鞋、0.5 cm负跟鞋、1 cm负跟鞋行走时的左侧胫骨前肌表面肌电信号RMS均低于穿2 cm负跟鞋行走时的左侧胫骨前肌表面肌电信号RMS(χ^(2)=-4.133,P=0.000;χ^(2)=-2.867,P=0.041;χ^(2)=-3.000,P=0.027),穿平底鞋行走时的左侧胫骨前肌表面肌电信号RMS低于穿1.5 cm负跟鞋行走时的左侧胫骨前肌表面肌电信号RMS(χ^(2)=-3.133,P=0.017)。④腓肠肌内侧头。受试者穿同一高度负跟鞋行走时,双侧腓肠肌内侧头表面肌电信号RMS比较,差异均无统计学意义[平底鞋:(50.13,28.83)μV,(51.75,30.80)μV,Z=-0.344,P=0.731;0.5 cm负跟鞋:(53.14,28.77)μV,(56.79,32.07)μV,Z=-0.246,P=0.806;1 cm负跟鞋:(53.04,27.31)μV,(54.46,26.19)μV,Z=-0.026,P=0.979;1.5 cm负跟鞋:(56.17,27.91)μV,(58.90,31.46)μV,Z=-0.064,P=0.949;2 cm负跟鞋:(53.36,34.45)μV,(58.19,32.32)μV,Z=-0.563,P=0.573]。受试者穿不同高度负跟鞋行走时,左侧腓肠肌内侧头表面肌电信号RMS两两比较,差异均无统计学意义。受试者穿平底鞋、0.5 cm负跟鞋、1 cm负跟鞋行走时的右侧腓肠肌内侧头表面肌电信号RMS均低于穿2 cm负跟鞋行走时的右侧腓肠肌内侧头表面肌电信号RMS(χ^(2)=-3.333,P=0.009;χ^(2)=-3.000,P=0.027;χ^(2)=-3.467,P=0.005)。结论:健康成人穿高度≤2 cm的负跟鞋短时间匀速直线行走,不会影响两侧腰腹肌和下肢肌收缩的对称性;负跟鞋高度对下肢肌活动影响较大,对腰腹肌无明显影响。

Objective:To investigate the effects of negative heel shoes of different heights on the activity of psoas and abdominal muscles and lower limb muscles in healthy adults.Methods:Forty-five healthy adults were enrolled,including 15 males and 30 females,with age of(34.87±12.79)years,height of(167.93±7.15)cm,and weight of(65.87±10.82)kg.The surface electromyography(EMG)signals of the bilateral rectus abdominis,paravertebral muscle,tibialis anterior,and medial head of the gastrocnemius muscle were measured using the BTS FreeEMG300 wireless surface EMG system while the participants walked in a straight line at a natural and uniform pace for seven walking cycles in five different heights of negative heel shoes(flat shoes,0.5 cm,1 cm,1.5 cm,and 2 cm negative heel shoes).The root mean square(RMS)of the surface EMG signals was calculated.Results:①Rectus abdominis.When the participants walked in negative heel shoes of the same height,there was no statistical difference in the RMS of the surface EMG signals between the bilateral rectus abdominis(flat shoes:(15.80,13.59)vs(17.81,11.70)μV,Z=-5.150,P=0.606;0.5 cm negative heel shoes:(16.58,11.77)vs(17.38,10.77)μV,Z=-0.125,P=0.901;1 cm negative heel shoes:(16.33,11.62)vs(17.25,12.12)μV,Z=-5.190,P=0.604;1.5 cm negative heel shoes:(17.50,11.51)vs(18.09,12.47)μV,Z=-0.023,P=0.981;2 cm negative heel shoes:(16.80,11.41)vs(17.64,10.86)μV,Z=-0.164,P=0.870).When the participants walked in negative heel shoes of different heights,there was no statistical difference in the RMS of the surface EMG signals of the ipsilateral rectus abdominis(left side:χ^(2)=9.191,P=0.056;right side:χ^(2)=8.645,P=0.071).②Paravertebral muscle.When the participants walked in negative heel shoes of the same height,there was no statistical difference in the RMS of surface EMG signals between the bilateral paravertebral muscle(flat shoes:(5.43,5.46)vs(5.65,3.45)μV,Z=-0.412,P=0.681;0.5 cm negative heel shoes:(6.04,5.25)vs(6.53,3.54)μV,Z=-0.198,P=0.843;1 cm negative heel shoes:(6.10,5.60)vs(6.00,4.21)μV,Z=-0.149,P=0.881;1.5 cm negative heel shoes:(5.85,5.82)vs(5.83,4.20)μV,Z=-0.222,P=0.824;2 cm negative heel shoes:(6.60,5.15)vs(5.73,4.41)μV,Z=-0.052,P=0.958).When the participants walked in negative heel shoes of different heights,there was no statistical difference in the RMS of surface EMG signals of the ipsilateral pa-ravertebral muscle(left side:χ^(2)=4.996,P=0.288;right side:χ^(2)=9.156,P=0.057).③Tibialis anterior.When the participants walked in negative heel shoes of the same height,there was no statistical difference in the RMS of surface EMG signals between the bilateral tibialis anterior(flat shoes:(51.27,39.27)vs(49.65,48.12)μV,Z=-0.399,P=0.690;0.5 cm negative heel shoes:(51.92,42.07)vs(54.11,46.61)μV,Z=-0.101,P=0.920;1 cm negative heel shoes:(51.46,39.79)vs(58.69,33.93)μV,Z=-0.488,P=0.625;1.5 cm negative heel shoes:(58.53,29.36)vs(49.16,47.71)μV,Z=-0.480,P=0.631;2 cm negative heel shoes:(56.26,41.17)vs(53.54,45.56)μV,Z=-0.246,P=0.806).When the participants walked in negative heel shoes of different heights,there was no sta-tistical difference in the RMS of surface EMG signals of the tibialis anterior on the right side(χ^(2)=5.831,P=0.212).The RMS of the sur-face EMG signals of the tibialis anterior on the left side when participants walked in flat shoes,0.5 cm negative heel shoes,and 1 cm nega-tive heel shoes was lower than that in 2 cm negative heel shoes(χ^(2)=-4.133,P=0.000;χ^(2)=-2.867,P=0.041;χ^(2)=-3.000,P=0.027).The RMS of the surface EMG signals of the tibialis anterior on the left side when participants walked in flat shoes was lower than that in 1.5 cm negative heel shoes(χ^(2)=-3.133,P=0.017).④Medial head of the gastrocnemius muscle.When the participants walked in negative heel shoes of the same height,there was no statistical difference in the RMS of surface EMG signals between the bilateral medial head of the gastrocnemius muscle(flat shoes:(50.13,28.83)vs(51.75,30.80)μV,Z=-0.344,P=0.731;0.5 cm negative heel shoes:(53.14,28.77)vs(56.79,32.07)μV,Z=-0.246,P=0.806;1 cm negative heel shoes:(53.04,27.31)vs(54.46,26.19)μV,Z=-0.026,P=0.979;1.5 cm negative heel shoes:(56.17,27.91)vs(58.90,31.46)μV,Z=-0.064,P=0.949;2 cm negative heel shoes:(53.36,34.45)vs(58.19,32.32)μV,Z=-0.563,P=0.573).When the participants walked in negative heel shoes of different heights,there was no statistical difference in the RMS of the surface EMG signals of the medial head of the gastrocnemius muscle on the left side.The RMS of the surface EMG signals of the medial head of the gastrocnemius muscle on the right side when participants walked in flat shoes,0.5 cm negative heel shoes,and 1 cm negative heel shoes was lower than that in 2 cm negative heel shoes(χ^(2)=-3.333,P=0.009;χ^(2)=-3.000,P=0.027;χ^(2)=-3.467,P=0.005).Conclusion:For healthy adults,walking in a straight line at a constant speed in nega-tive heel shoes with a height of≤2 cm does not affect the symmetry of the contraction of the bilateral psoas muscles,abdominal muscles,and muscle of lower limb.The height of the negative heel shoes has a significant impact on the activity of the muscle of lower limb but has no significant effect on the psoas and abdominal muscles.