اثر آنی کفی حمایت کننده قوس طولی- داخلی بر زوایای کاپلینگ بین مفاصل طی راه رفتن در کودکان دارای کف پای صاف

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار بیومکانیک ورزشی، دانشکده روانشناسی و علوم تربیتی، دانشگاه محقق اردبیلی، اردبیل، ایران

2 دانشجوی کارشناسی ارشد بیومکانیک ورزشی، دانشگاه محقق اردبیلی، اردبیل، ایران.

3 استادیار بیومکانیک ورزشی، دانشکده ادبیات و علوم انسانی، دانشگاه آزاد اسلامی، واحد همدان، همدان، ایران.

چکیده

مقدمه و اهداف
افراد دارای کف پای صاف دچار اختلالات حسی-حرکتی هستند که بر روی هماهنگی مفاصل اندام تحتانی اثر می­گذارد. هدف مطالعه حاضر مقایسه زوایای کاپلینگ بین مفاصل اندام تحتانی در طی راه رفتن با و بدون کفی حمایت­کننده قوس طولی-داخلی پا در کودکان دارای کف پای صاف منعطف بود.
مواد و روش ­ها
15 کودک پسر (سن: 5/1±3/10 سال) دارای کف پای صاف منعطف با اجازه والدین خود داوطلب شدند تا در پژوهش حاضر شرکت نمایند. داده­های کینماتیکی سه­بعدی طی راه رفتن با و بدون کفی ثبت گردید. زوایای کاپلینگ بین مفاصل با استفاده از روش وکتور کدینگ مورد محاسبه قرار گرفت. جهت تحلیل آماری از آزمون t همبسته استفاده شد. سطح معناداری برابر 05/0 قرار گرفت.
یافته­ ها
نتایج پژوهش حاضر اختلاف معناداری را در میانگین زوایای کاپلینگ مفاصل مچ پا و زانو طی فاز پاسخ بارگیری بین دو شرایط با و بدون ارتز در سطح سجیتال (002/0=P) و فرونتال (035/0=P) نشان داد؛ در حالی که نتایج نشان داد که ارتز پا میزان زاویه کاپلینگ بین زانو-ران در صفحه هوریزنتال را طی فازهای پاسخ­های بارگیری (008/0=P)، میانه استقرار (009/0=P) و هل دادن (001/0>P) راه رفتن افزایش می­دهد. به علاوه، زاویه کاپلینگ بین مفاصل مچ پا و ران در صفحه هوریزنتال در طی شرایط راه رفتن با ارتز  در دو فاز پاسخ بارگیری و میانه استقرار به طور معناداری افزایش پیدا نمود (05/0>P).
نتیجه­ گیری
در شرایط استفاده از ارتز میزان فلکشن زانو بیشتر از حرکت موجود در صفحه سجیتال مفصل مچ پا است که می­توان بیان نمود که کفی مورد استفاده در این مورد اثرات مثبتی را در جهت کاهش نرخ بروز آسیب دارا بوده است. ارتز مورد استفاده در پژوهش حاضر در کودکان پسر دارای کف پای صاف بیشترین تغییرات در زوایای کاپلینگ بین مفصلی اندام تحتانی را در طی فاز پاسخ بارگیری ایجاد نمود. با این وجود، اثبات این امر نیاز به انجام پژوهش­های بیشتر دارد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Immediate Effect of Arch Support Foot Orthoses on Lower Limb Intera-Joint Coupling Angles during Walking in Children with Flat Foot

نویسندگان [English]

  • AmirAli Jafarnezhadgero 1
  • Seyed Mijid Alavi Mehr 2
  • Mahdi Majlesi 3
1 Department of Physical Education and Sport Science, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2 Department of Physical Education and Sport Sciences, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3 Department of Sport Biomechanics, Faculty of Humanities, Islamic Azad University, Hamedan Branch, Hamedan, Iran.
چکیده [English]

Background and Aims: Individuals with flat foot may have sensorimotor impairments that affect coordination at the lower limb joints. The purpose of the present study was to compare joint coupling angles of the lower limbs during walking with and without arch support foot orthoses in children with flexible flat foot.
Materials and Methods: A total of 15 male teenagers (age: 10.3±1.5 year) with flexible flat foot, after obtaining their parents’ permission, volunteered to participate in the study. Three-dimensional kinematic data were collected while subjects walk with and without arch support foot orthoses. The intra-joint coupling angles were calculated using a vector coding technique. Paired sample t-test was used for statistical analysis. Alpha level was set at PResults: The results demonstrated that there are significant differences in ankle-knee intra-joint coupling angles in both sagittal (P=0.002) and frontal (P=0.035) planes between the control and experimental groups during loading response phase, while the results also demonstrated that foot orthotic device reduce horizontal knee–hip coupling angle significantly during loading response (P=0.008), mid stance (P=0.009), and push off (P<0.001) phases of walking. Moreover, horizontal ankle-hip coupling angle significantly increased during foot orthoses condition in both loading response and midstanc phases (P<0.05).
Conclusions: During orthoses condition, knee flexion angle was greater than that of sagittal ankle joint motion. This indicated positive effects of orthoses in injury prevention. The arch support foot orthoses that was used in the present study in male children with flat foot caused the highest alterations in lower limb intra-joint coupling angles in loading response phase. However, further study is needed to prove thie claim.

کلیدواژه‌ها [English]

  • Vector Coding
  • Flat foot: Foot Orthoses: Lower Limb
1.   Kosonen J, Kulmala J-P, Müller E, Avela J. Effects of medially posted insoles on foot and lower limb mechanics across walking and running in overpronating men. Journal of Biomechanics. 2017;54:58-63.##
2.   Jafarnezhadgero A, Shad MM, Ferber R. The effect of foot orthoses on joint moment asymmetry in male children with flexible flat feet. Journal of Bodywork and Movement Therapies. 2017. ##
3.   Jafarnezhadgero AA, Shad MM, Majlesi M. Effect of foot orthoses on the medial longitudinal arch in children with flexible flatfoot deformity: A three-dimensional moment analysis. Gait & Posture. 2017;55:75-80. ##
4.   Malvasi S, Gloyeske B, Johnson M, Miller T. Multi-Ligamentous Knee Injury in Sports Involving Concomitant Anterior Cruciate Ligament and Patellar Tendon Disruption: A Review of Case Reports. International Journal of Athletic Therapy and Training. 2016;21(3):24-7. ##
5.   Augustsson SR, Ageberg E. Weaker lower extremity muscle strength predicts traumatic knee injury in youth female but not male athletes. BMJ Open Sport & Exercise Medicine. 2017;3(1):e000222. ##
6.   Taunton JE, Ryan MB, Clement D, McKenzie DC, Lloyd-Smith D, Zumbo B. A retrospective case-control analysis of 2002 running injuries. British journal of sports medicine. 2002;36(2):95-101. ##
7.   Collins NJ, Hinman RS, Menz HB, Crossley KM. Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study. The Knee. 2016. ##
8.   Shih Y-F, Wen Y-K, Chen W-Y. Application of wedged foot orthosis effectively reduces pain in runners with pronated foot: a randomized clinical study. Clinical rehabilitation. 2011;25(10):913-23. ##
9.   Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Bmj. 2008;337:a1735. ##
10. Twomey D, McIntosh A, Simon J, Lowe K, Wolf S. Kinematic differences between normal and low arched feet in children using the Heidelberg foot measurement method. Gait & posture. 2010;32(1):1-5. ##
11. Wyndow N, Crossley KM, Vicenzino B, Tucker K, Collins NJ. A single-blinded, randomized, parallel group superiority trial investigating the effects of footwear and custom foot orthoses versus footwear alone in individuals with patellofemoral joint osteoarthritis: a phase II pilot trial protocol. Journal of foot and ankle research. 2017;10(1):19. ##
12. Liu A, Nester CJ, Jones RK, Lundgren P, Lundberg A, Arndt A, et al. Effect of an antipronation foot orthosis on ankle and subtalar kinematics. Medicine and science in sports and exercise. 2012;44(12):2384-91. ##
13. Eslami M, Begon M, Hinse S, Sadeghi H, Popov P, Allard P. Effect of foot orthoses on magnitude and timing of rearfoot and tibial motions, ground reaction force and knee moment during running. Journal of Science and Medicine in Sport. 2009;12(6):679-84. ##
14. Rodgers MM, Leveau BF. Effectiveness of foot orthotic devices used to modify pronation in runners. Journal of Orthopaedic & Sports Physical Therapy. 1982;4(2):86-90. ##
15. Herb CC, Chinn L, Hertel J. Altering Shank–Rear-Foot Joint Coupling during Gait with Ankle Taping in Patients with Chronic Ankle Instability and Healthy Controls. Journal of sport rehabilitation. 2016;25(1):13-22. ##
16. Inman VT. The joints of the ankle: Williams & Wilkins; 1976. ##
17. Lundberg A, Svensson OK, Bylund C, Goldie I, Selvik G. Kinematics of the ankle/foot complex—part 2: pronation and supination. Foot & ankle. 1989;9(5):248-53. ##
18. Herb CC, Chinn L, Dicharry J, McKeon PO, Hart JM, Hertel J. Shank-rearfoot joint coupling with chronic ankle instability. Journal of applied biomechanics. 2014;30(3):366-72. ##
19. Hamill J, Knutzen KM. Biomechanical basis of human movement: Lippincott Williams & Wilkins; 2006. ##
20. Nawoczenski DA, Saltzman CL, Cook TM. The effect of foot structure on the three-dimensional kinematic coupling behavior of the leg and rear foot. Physical therapy. 1998;78(4):404-16. ##
21. Stacoff A, Reinschmidt C, Nigg B, van den Bogert AJ, Lundberg A, Denoth J, et al. Effects of foot orthoses on skeletal motion during running. Clinical Biomechanics. 2000;15(1):54-64.v
22. Williams III DS, McClay IS, Hamill J, Buchanan TS. Lower extremity kinematic and kinetic differences in runners with high and low arches. Journal of applied biomechanics. 2001;17(2):153-63. ##
23. Wilken J, Rao S, Saltzman C, Yack HJ. The effect of arch height on kinematic coupling during walking. Clinical Biomechanics. 2011;26(3):318-23. ##
24. Resende RA, Deluzio KJ, Kirkwood RN, Hassan EA, Fonseca ST. Increased unilateral foot pronation affects lower limbs and pelvic biomechanics during walking. Gait & posture. 2015;41(2):395-401. ##
25. Souza TR, Pinto RZ, Trede RG, Kirkwood RN, Pertence AE, Fonseca ST. Late rearfoot eversion and lower-limb internal rotation caused by changes in the interaction between forefoot and support surface. Journal of the American Podiatric Medical Association. 2009;99(6):503-11. ##
26. McClay I, Manal K. A comparison of three-dimensional lower extremity kinematics during running between excessive pronators and normals. Clinical Biomechanics. 1998;13(3):195-203. ##
27. Heiderscheit BC, Hamill J, van Emmerik RE. Variability of stride characteristics and joint coordination among individuals with unilateral patellofemoral pain. Journal of applied biomechanics. 2002;18(2):110-21. ##
28. Sparrow W, Donovan E, Van Emmerik R, Barry E. Using relative motion plots to measure changes in intra-limb and inter-limb coordination. Journal of Motor Behavior. 1987;19(1):115-29. ##
29. Nawoczenski DA, Cook TM, Saltzman CL. The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. Journal of Orthopaedic & Sports Physical Therapy. 1995;21(6):317-27. ##
30. Ferber R, Davis IM, Williams DS. Effect of foot orthotics on rearfoot and tibia joint coupling patterns and variability. Journal of biomechanics. 2005;38(3):477-83. ##
31. Liao S. The effect of orthotic insole on coupling mechanism of flatfoot in Gait. Foot and Ankle Surgery. 2016;22(2):26. ##
32. MacKinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. Journal of biomechanics. 1993;26(6):633-44. ##
33. Yen S-C, Chui KK, Corkery MB, Allen EA, Cloonan CM. Hip-ankle coordination during gait in individuals with chronic ankle instability. Gait & Posture. 2017;53:193-200. ##
34. Lange B, Chipchase L, Evans A. The effect of low-Dye taping on plantar pressures, during gait, in subjects with navicular drop exceeding 10 mm. Journal of Orthopaedic & Sports Physical Therapy. 2004;34(4):201-9. ##
35. Jafarnezhadgero AA, Majlesi M, Azadian E. Gait ground reaction force characteristics in deaf and hearing children. Gait & Posture. 2017;53:236-40. ##
36. Kadaba MP, Ramakrishnan H, Wootten M. Measurement of lower extremity kinematics during level walking. Journal of orthopaedic research. 1990;8(3):383-92. ##
37. Wolf S, Simon J, Patikas D, Schuster W, Armbrust P, Döderlein L. Foot motion in children shoes—A comparison of barefoot walking with shod walking in conventional and flexible shoes. Gait & posture. 2008;27(1):51-9. ##
38. Lythgo N, Wilson C, Galea M. Basic gait and symmetry measures for primary school-aged children and young adults whilst walking barefoot and with shoes. Gait & posture. 2009;30(4):502-6. ##
39. Hamill J, Haddad JM, McDermott WJ. Issues in quantifying variability from a dynamical systems perspective. Journal of Applied Biomechanics. 2000;16(4):407-18. ##
40. Batschelet E. Circular statistics in biology (Academic, London). BatscheletCircular Statistics in Biology1981. 1981. ##
41. Cohen J. A power primer. Psychological bulletin. 1992;112(1):155. ##
42. Winter DA. Foot trajectory in human gait: a precise and multifactorial motor control task. Physical therapy. 1992;72(1):45-53. ##
43. Krasovsky T, Levin MF. Review: toward a better understanding of coordination in healthy and poststroke gait. Neurorehabilitation and Neural Repair. 2010;24(3):213-24. ##
44. Liikavainio T, Isolehto J, Helminen HJ, Perttunen J, Lepola V, Kiviranta I, et al. Loading and gait symmetry during level and stair walking in asymptomatic subjects with knee osteoarthritis: importance of quadriceps femoris in reducing impact force during heel strike? The Knee. 2007;14(3):231-8. ##
45. Nigg BM, Stergiou P, Cole G, Stefanyshyn D, Mündermann A, Humble N. Effect of shoe inserts on kinematics, center of pressure, and leg joint moments during running. Medicine and science in sports and exercise. 2003;35(2):314-9. ##
46. Telfer S, Abbott M, Steultjens M, Rafferty D, Woodburn J. Dose–response effects of customised foot orthoses on lower limb muscle activity and plantar pressures in pronated foot type. Gait & posture. 2013;38(3):443-9. ##
47. Nester C, Van Der Linden M, Bowker P. Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait & posture. 2003;17(2):180-7. ##
48. Kakihana W, Akai M, Nakazawa K, Takashima T, Naito K, Torii S. Effects of laterally wedged insoles on knee and subtalar joint moments. Archives of physical medicine and rehabilitation. 2005;86(7):1465-71. ##
49. Robertson G, Caldwell G, Hamill J, Kamen G, Whittlesey S. Research methods in biomechanics, 2E: Human Kinetics; 2013. ##
50. Bernstein NA. The co-ordination and regulation of movements. 1967. ##
51. Hafer JF, Boyer KA. Variability of segment coordination using a vector coding technique: Reliability analysis for treadmill walking and running. Gait & Posture. 2017;51:222-7. ##
52. Newell K. Coordination, control and skill. Advances in Psychology. 1985;27:295-317. ##
53. Hsu W-L, Chou L-S, Woollacott M. Age-related changes in joint coordination during balance recovery. Age. 2013;35(4):1299-309. ##
54. Hamill J, Palmer C, Van Emmerik RE. Coordinative variability and overuse injury. BMC Sports Science, Medicine and Rehabilitation. 2012;4(1):45. ##
55. Chiu S-L, Chou L-S. Variability in inter-joint coordination during walking of elderly adults and its association with clinical balance measures. Clinical biomechanics. 2013;28(4):454-8. ##
56. Kelso JS. Dynamic patterns: The self-organization of brain and behavior: MIT press; 1997. ##
57. Scholz JP. Dynamic pattern theory—some implications for therapeutics. Physical therapy. 1990;70(12):827-43. ##
دوره 7، شماره 2
خرداد و تیر 1397
صفحه 65-75
  • تاریخ دریافت: 07 تیر 1396
  • تاریخ بازنگری: 13 شهریور 1396
  • تاریخ پذیرش: 25 شهریور 1396
  • تاریخ اولین انتشار: 01 تیر 1397