背景:多段足部模型(MFMs)提供了对足部复杂生物力学的更好理解,然而,目前尚不清楚他们是否准确区分运动过程中的足型功能。
目的:我们使用MFM来检测脚型之间细微的运动学差异,包括:pescavus,中性对齐,无症状和有症状的扁平苔藓。该研究调查了该MFM的结果如何变化,以及它是否可以在步态的站立阶段检测到病理性和非病理性足部类型之间的运动学差异。
方法:独立,三名评估者在三天内对三名受试者进行了仪器测试,以评估变异性。在一个单独的队列中,对每组10名受试者的每种足部类型进行静态量化.每个受试者在使用四段脚模型进行测量的同时行走,以评估步态站立阶段的静态对准和脚运动。用线性混合效应回归进行统计分析。
结果:模型变异性在日之间最高,在评分者之间最低,所有变异性度量都在真实样本方差范围内。几乎所有静态测量(射线照相,数字扫描,和运动学标记)因脚类型而异。在站立后期,后脚到腿和前脚到腿的矢状运动学在不同类型的脚之间有所不同,以及冠状幻觉到前脚的运动范围。MFM具有低的评分者间变异性,并且可以适合于多个评分者应用于单个研究样本而不引入显著误差。模型,然而,只检测到一些动态差异,最戏剧性的是幻觉到前脚冠状平面的运动范围。
结论:结果仅与以前的工作有一定的一致性。尚不清楚MFM是否足够灵敏以准确检测足部类型(病理性和非病理性)之间的不同运动。一种更准确的跟踪脚骨运动的方法(例如,双平面透视)可能需要解决这个问题。
BACKGROUND: Multi-segment foot models (MFMs) provide a better understanding of the intricate biomechanics of the foot, yet it is unclear if they accurately differentiate foot type function during locomotion.
OBJECTIVE: We employed an MFM to detect subtle kinematic differences between foot types, including: pes cavus, neutrally aligned, and asymptomatic and symptomatic pes planus. The study investigates how variable the results of this MFM are and if it can detect kinematic differences between pathologic and non-pathologic foot types during the stance phase of gait.
METHODS: Independently, three raters instrumented three subjects on three days to assess variability. In a separate cohort, each foot type was statically quantified for ten subjects per group. Each subject walked while instrumented with a four-segment foot model to assess static alignment and foot motion during the stance phase of gait. Statistical analysis performed with a linear mixed effects regression.
RESULTS: Model variability was highest for between-day and lowest for between-rater, with all variability measures being within the true sample variance. Almost all static measures (radiographic, digital scan, and kinematic markers) differed significantly by foot type. Sagittal hindfoot to leg and forefoot to leg kinematics differed between foot types during late stance, as well as coronal hallux to forefoot range of motion. The MFM had low between-rater variability and may be suitable for multiple raters to apply to a single study sample without introducing significant error. The model, however, only detected a few dynamic differences, with the most dramatic being the hallux to forefoot coronal plane range of motion.
CONCLUSIONS: Results only somewhat aligned with previous work. It remains unclear if the MFM is sensitive enough to accurately detect different motion between foot types (pathologic and non-pathologic). A more accurate method of tracking foot bone motion (e.g., biplane fluoroscopy) may be needed to address this question.