Abstract：
BACKGROUND: There are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity. In this study, we aim to compare the activities of quadriceps, hamstrings, and gastrosoleus muscle groups of adult patients with PCFD with normal lower limbs and correlate the radiological parameters and functional effects of PCFD with the activities.
METHODS: Thirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch.
RESULTS: Electrical activities of all muscle groups were significantly higher in cases than controls. Meary\'s angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041).
CONCLUSIONS: The PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association.
UNASSIGNED: Diagnostic: Level 3.
METHODS: Thirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch.
RESULTS: Electrical activities of all muscle groups were significantly higher in cases than controls. Meary\'s angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041).
CONCLUSIONS: The PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association.
UNASSIGNED: Diagnostic: Level 3.
摘要：
背景：在进行性塌陷性足部畸形（PCFD）的频谱中描述了各种畸形，这些畸形不仅对足部而且对整个下肢都有不利影响。运动时早期下肢肌肉疲劳和疼痛是PCFD患者最常见的主诉。表面肌电图（sEMG）可准确评估肌肉活动。在这项研究中,我们的目的是比较股四头肌的活动，腿筋,和下肢正常的成人PCFD患者的腹肌群，并将PCFD的放射学参数和功能作用与活动相关。
方法：30例双侧PCFD患者和30例对照者接受负重前后（AP），横向,和脚的后足对准射线照片。评估了PCFD的射线照相参数。表面肌电图用于评估股四头肌，腿筋,和腹肌活动，并在两组之间进行比较，并与PCFD的放射学测量结果相关。Tegner活动问卷用于评估塌陷弓的功能影响。
结果：病例中所有肌肉群的电活动均明显高于对照组。米里角和后足力矩臂与腿筋活动(P=.013)和腹肌活动(P=.027)有显著相关性，分别。病例的Tegner评分明显低于对照组(P=.041)。
结论：PCFD导致受影响的下肢大肌肉的活动增加，这些肌肉作用于足部以外的关节。这一发现可能是由于几种补偿机制抵消了变形力。这可能是经常抱怨的原因，早期疲劳,因此功能受损。然而,大多数放射学参数与肌肉活动无关,可能需要更大的研究规模才能进一步关联.
■诊断：3级。
方法：30例双侧PCFD患者和30例对照者接受负重前后（AP），横向,和脚的后足对准射线照片。评估了PCFD的射线照相参数。表面肌电图用于评估股四头肌，腿筋,和腹肌活动，并在两组之间进行比较，并与PCFD的放射学测量结果相关。Tegner活动问卷用于评估塌陷弓的功能影响。
结果：病例中所有肌肉群的电活动均明显高于对照组。米里角和后足力矩臂与腿筋活动(P=.013)和腹肌活动(P=.027)有显著相关性，分别。病例的Tegner评分明显低于对照组(P=.041)。
结论：PCFD导致受影响的下肢大肌肉的活动增加，这些肌肉作用于足部以外的关节。这一发现可能是由于几种补偿机制抵消了变形力。这可能是经常抱怨的原因，早期疲劳,因此功能受损。然而,大多数放射学参数与肌肉活动无关,可能需要更大的研究规模才能进一步关联.
■诊断：3级。
