Zhongguo quanke yixue (Nov 2022)
Distribution Pattern of Dynamic Plantar Pressure in Patients with Traumatic Extension Knee Contracture
Abstract
Background Traumatic extensor knee contracture is very common in clinic, and most patients have gait abnormalities. In clinical rehabilitation, the assessment of gait is mostly performed using scales and balance instruments. Dynamic plantar pressure test, as a scientific and objective assessment method, has been widely used in the assessment of lower limb diseases. The use of dynamic plantar pressure test in patients with traumatic extensor knee contracture is less common both nationally and internationally. Objective To investigate the distribution pattern of dynamic plantar pressure in patients with traumatic extensor knee contracture, and to provide data support for guiding rehabilitation assessment and gait training. Methods From December 2020 to December 2021, 35 patients with traumatic extensor knee contracture who were treated in the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Anhui Medical University were selected as the study group, and 30 healthy individuals with normal gait who volunteered to participate in this study during the same period were selected as the control group. ByGait-G6060-5 gait analysis system measuring instrument was used to collect the plantar pressure parameters of the two groups of subjects. The step length, step width, step speed, foot angle, total touchdown time, the proportion of plantar pressure in each area〔hallux toe (T1 area), second to fifth toe (T2 area), first metatarsal (M1 area), second metatarsal (M2 area), third metatarsal (M3 area), fourth metatarsal (M4 area), fifth metatarsal (M5 area), middle plantar (MF area), medial heel (MH area), lateral heel (LH area) 〕, the total plantar pressure Ad value, the maximum deviation distance (COP-X deviation) of plantar pressure center in the lateral (left-right body direction) and the maximum deviation distance (COP-Y deviation) of plantar pressure center in the longitudinal (anterior-posterior body direction) of the two groups were compared and analyzed. Results The step length of the study group was shorter than that of the control group, the step width and total touchdown time were longer than those of the control group, the step speed was slower than that of the control group, and the foot angle was higher than that of the control group (P<0.05). The proportions of plantar pressure in T2, M4 and M5 areas in the study group were higher than those in the control group, and the proportions of plantar pressure in MH and LH areas were lower than those in the control group (P<0.05). The total pressure Ad value on the affected side was lower than that on the healthy side in the study group (P<0.01). The difference was not statistically significant when comparing the percentage of total pressure Ad values on the left side with the right side in the control group (P>0.05). The deviation values in both the COP-X direction and COP-Y direction were higher in the study group than in the control group (P<0.05) . Conclusion The patients with traumatic extensor knee contracture have short stride length, wide based gait, slow pace, large foot angle and long total touchdown time of both feet, less weight-bearing of the affected side of the lower extremity during walking, and predominantly weight-bearing of the forefoot and lateral edge of the foot, with a greater lateral and longitudinal displacement of center of pressure trajectories across both feet, large sloshing and poor stability during walking.
Keywords
