文章摘要
李阳,姜淑云,张进,李一瀛,俞艳,鲁潇莹.不同严重程度柔韧性扁平足对学龄期儿童步行功能的影响[J].中国康复,2022,37(9):523-527
不同严重程度柔韧性扁平足对学龄期儿童步行功能的影响
Effect of different severity of flexible flatfoot on walking function in school-age children
  
DOI:
中文关键词: 学龄期儿童  柔韧性扁平足  步态分析  步行功能
英文关键词: school-age children  flexible flatfoot  gait analysis  walking function
基金项目:国家自然科学基金(82105040);上海市科技创新行动计划软科学重点项目(青年)(20692193800);上海市卫生健康委员会卫生行业临床研究专项(20194Y0024)
作者单位
李阳 上海中医药大学附属岳阳中西医结合医院步态与运动分析中心上海 200437 
姜淑云 上海中医药大学附属岳阳中西医结合医院步态与运动分析中心上海 200437 
张进 上海中医药大学上海 201203 
李一瀛 上海中医药大学附属岳阳中西医结合医院步态与运动分析中心上海 200437 
俞艳 上海中医药大学附属岳阳中西医结合医院步态与运动分析中心上海 200437 
鲁潇莹 上海中医药大学附属岳阳中西医结合医院步态与运动分析中心上海 200437 
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中文摘要:
  目的:探究不同严重程度的柔韧性扁平足对学龄期儿童步行功能的影响。方法:按照临床扁平足分级标准纳入轻、中、重度柔韧性扁平足儿童各30例及正常儿童30例,应用三维运动解析系统进行步行状态下的数据采集,将各组数据进行比较,分析不同严重程度扁平足对学龄期儿童步行功能的影响。结果:与正常儿童组相比,扁平足儿童组步长、步速、踝关节最大背屈角度以及支撑相平均足内翻角度明显减小(P<0.01);步宽、支撑相所占时间百分比及内外方向地反力第一峰值明显增加(P<0.01);足触地时刻膝关节屈曲角度及髋关节最大外旋角度明显减小(P<0.05)。轻度组在足触地时刻踝跖屈角度较正常组明显增加(P<0.01),足外偏角度及髋关节屈伸运动范围明显减小(P<0.01);摆动相膝关节最大屈曲角度明显低于中、重度组及正常组(P<0.05)。中度组膝关节支撑相平均外翻角度明显低于重度组及正常组(P<0.01)。轻、中度组髋关节最大功率较正常组明显减小(P<0.05)。重度组踝关节屈伸运动幅度及踝关节最大内翻力矩较正常组明显减低(P<0.05)。结论:不同严重程度扁平足对学龄期儿童的步行效率、步行平衡稳定性以及关节协调运动功能等均会造成显著影响;轻度扁平足儿童在关节协调运动方面异常表现多于中、重度扁平足儿童。扁平足对学龄期儿童步行功能的影响未表现出随严重程度进展而不断加深的特点。
英文摘要:
  Objective: To investigate the effect of different severity of flexible flatfoot on walking function in school-age children. Methods: In this study, 30 children with mild, moderate or severe flexible flatfoot and 30 normal children were included according to the clinical flatfoot grading criteria, and the data were collected under walking condition by applying the 3D motion analysis system, and the data of each group were compared to analyze the effects of different severity of flatfoot on the walking function of school-age children. Results: Compared with the normal children group, the step length, step speed, maximum ankle dorsiflexion angle, and average ankle inversion angle in stance phase were significantly reduced in the children with flat feet group (P<0.01); the step width, the percentage of stance phase and the first peak value of the ground reaction force in the internal and external directions increased significantly (P<0.01); the knee flexion angle and the maximum external rotation angle of the hip joint on initial contact decreased significantly (P<0.05). In the mild group, the ankle plantarflexion angle on initial contact was significantly increased as compared with the normal group (P<0.01), and the foot external orientation angle and hip flexion and extension range of motion were significantly reduced (P<0.01); the maximum knee flexion angle in swing phase was significantly reduced as compared with that in the moderate and severe groups and the normal group (all P<0.05). The mean valgus angle of the knee joint in stance phase of the moderate group was significantly lower than that of the severe group and the normal group (P<0.01). The maximum power of the hip joint was significantly reduced in the mild and moderate groups as compared with that in the normal group (P<0.05). The amplitude of ankle flexion and extension motion and the maximum inversion moment of the ankle joint were significantly reduced in the severe group as compared with those in the normal group (P<0.05). Conclusion: The effects of different severity of flatfoot on walking efficiency, walking stability, and joint coordination in school-age children were significant; children with mild flatfoot showed more abnormalities in joint coordination than children with moderate or severe flatfoot. The effects of flatfoot on walking function in school-age children did not show a progressive effect with increasing severity.
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