青少年特发性脊柱侧弯症患者的足底压力差异分析及穿戴矫形鞋垫的影响

发布时间：2019-04-26 13:54

【摘要】：【目的】分析青少年特发性脊柱侧弯症(AIS)患者的足底压力指标,探讨AIS患者的足底压力特征。【方法】选取2015年10月至2017年3月中山大学附一院东院康复科就诊的AIS患者56例,以脊柱侧弯方向的不同分为3组:右侧弯18例,左侧弯18例,S型脊柱胸腰段侧弯20例;另选同期健康对照组19例。对4组受试者的双侧足总压力,前半足、后半足压力等生物力学指标进行检测和比较,以分析不同类型AIS患者和健康人的足底压力分布特征。对3组穿戴了矫形鞋垫的患者,分析其穿鞋垫前后足底压力变化,并对穿着矫形鞋垫条件下重新拍摄脊柱全长片的患者,分析其Cobb角度的变化。【结果】与对照组相比,右侧弯组患者的左足平均压力、左前半足压力小于对照组,右足平均压力、右后半足压力大于对照组(P0.017)。左侧弯组患者的右前半足压力小于对照组,右后半足压力大于对照组(P0.017)。S型胸腰弯组左前半足压力小于对照组。右侧弯组左足平均压力(44.7%±6.0%)明显小于右足平均压力(55.4%±6.0%),差异具有统计学意义(P0.05),左侧弯组、S型胸腰弯组与对照组左右足底压力无差异。配制矫形鞋垫后,即刻为患者测量穿戴矫形鞋垫时的足底压力,单弯型脊柱侧弯(左侧弯或右侧弯)患者足底压力分布存在差异,而S型胸腰弯组患者穿戴前后足底压力无差异。患者在穿戴矫形鞋垫前后Cobb角度对比没有统计学意义(P=0.102)。【结论】右侧弯患者的左右足底压力对称性较差,S型胸腰弯患者的左、右足底压力呈现对称。矫形鞋垫可以有效调整单弯型脊柱侧弯(左或右侧弯)患者的足底压力分布,但对于患者侧弯角度的影响还需要进一步的跟踪观察。
[Abstract]:[objective] to analyze the index of plantar pressure in (AIS) patients with adolescent idiopathic scoliosis. To investigate the characteristics of plantar pressure in patients with AIS. [methods] 56 patients with AIS from October 2015 to March 2017 in the rehabilitation department of East Hospital of Sun Yat-sen University affiliated Hospital were selected and divided into three groups according to the different directions of scoliosis: right bend in 18 cases and left bend in 18 cases. S-type thoracolumbar scoliosis in 20 cases; Another 19 cases of healthy control group in the same period were selected. In order to analyze the characteristics of plantar pressure distribution in different types of AIS patients and healthy people, biomechanical indexes such as bilateral total foot pressure, anterior half-foot pressure, and posterior half-foot pressure were measured and compared among the four groups of subjects in order to analyze the characteristics of foot pressure distribution in different types of patients and healthy people. Three groups of patients wearing orthopaedic insoles were analyzed for the change of plantar pressure before and after insole wearing, and the changes of Cobb angle were analyzed for the patients with orthopaedic insoles re-photographing full-length spine film under the condition of orthopaedic insole. [results] compared with the control group, the changes of foot pressure before and after insole wearing were analyzed. The mean pressure of the left foot and the left front half of the patients in the right bending group were lower than those of the control group, and the mean pressure of the right foot and the right half of the right foot were higher than those of the control group (P 0.017). The pressure of the right anterior half in the left bending group was lower than that in the control group, and the pressure in the right posterior half was greater than that in the control group (P0.017). The left anterior hemipod pressure in the left bending group was smaller than that in the control group. The mean pressure of left foot (44.7% 卤6.0%) in the right bending group was significantly lower than that in the right foot (55.4% 卤6.0%), the difference was statistically significant (P0.05). There was no difference in the left and right plantar pressure between the S-type thoracolumbar bending group and the control group. After the preparation of orthopaedic insole, the plantar pressure of patients wearing orthopaedic insoles was measured immediately, and there were differences in the distribution of plantar pressure in patients with single curved scoliosis (left or right). There was no difference in plantar pressure before and after wearing in S-type thoracolumbar bending group. There was no significant difference in Cobb angle before and after wearing orthopedic insoles (P = 0.102). [conclusion] the left and right plantar pressure of patients with S-type thoracolumbar bending is symmetrical. [conclusion] the left and right plantar pressure in patients with right bend is less symmetrical than that in patients with S-type thoracolumbar bending. Orthopaedic insoles can effectively adjust the plantar pressure distribution in patients with single curved scoliosis (left or right), but the influence on the angle of lateral bending needs further follow-up observation.
【作者单位】：中山大学附属第一医院东院康复医学科;中山大学附属第一医院东院护理部;中山大学附属第一医院康复医学科;
【基金】：广东省科技计划项目(2008B080703036)
【分类号】：R726.8

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