应用三维步态分析技术评价儿童特发性足内偏的步态参数特征

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摘要目的通过对比健康对照组与足内偏组儿童的三维步态数据特征，总结足内偏儿童的步态特征及足内偏的影响因素，为足内偏儿童的早期评估及干预提供科学依据。方法选择2019年1月至2021年9月上海中医药大学附属岳阳中西医结合医院步态与运动分析中心门诊的48例足内偏儿童，其中男23例，女25例；年龄5~10岁，平均(7.75±1.55)岁。同时于正常儿童数据库中收集48例健康步态儿童的三维步态数据资料，其中男29例，女19例；年龄范围5~10岁，平均(7.81±2.13)岁。分析并总结足内偏儿童的步态参数特征及影响因素。结果 (1)足内偏组儿童的时空参数表现为步宽增加(P＜0.01)；(2)足内偏组儿童的运动学参数表现为髋关节最大内旋角度增加(P＜0.05)，髋关节最大屈曲角度、膝关节最大内旋角度及踝关节最大内旋角度明显增加(P＜0.01)，踝关节最大背屈角度减少(P＜0.05)；(3)足内偏组儿童的动力学参数表现为髋关节最大屈曲力矩增加(P＜0.05)、最大外展力矩及最大功率减少(P＜0.05)，膝关节支撑相初期内收力矩峰值及最大功率明显增加(P＜0.01)，踝关节最大跖屈力矩明显减少(P＜0.01)；(4)髋、膝、踝关节最大内旋角度，踝关节最大背屈角度及髋关节最大外展力矩与足内偏存在显著的线性关系(P＜0.05)。结论足内偏组儿童的时空、运动学和动力学参数与健康对照组儿童相比明显不同，足内偏的影响因素包括髋、膝、踝关节最大内旋角度，踝关节最大背屈角度及髋关节最大外展力矩。

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	张亚茹
	李阳
	李一瀛
	俞艳
	鲁潇滢
	姜淑云

关键词 ：足内偏, 儿童, 步态特征, 三维步态分析

Abstract：Objective To study the gait characteristics of the intoeing children and the influencing factors of intoeing children and provide a scientific basis for early assessment and intervention of intoeing children.Methods From January 2019 to September 2021，48 children with intoeing were selected from the outpatient department of Gait and Motion Analysis Center of Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.23 males and 25 females were included.The age ranged from 5 to 10 years，with an average of (7.75±1.55)years.At the same time，the 3D gait data of 48 healthy children were collected from the database of normal children，including 29 males and 19 females.The age ranged from 5 to 10 years，with an average of (7.81±2.13)years.To analyze and summarize the characteristics and influencing factors of gait parameters in children with intoeing.Results (1)The spatial and temporal parameters of children with intoeing were increased by step width (P＜0.01).(2)The kinematic parameters of children with intoeing group showed that the maximum internal rotation angle of hip joint increased (P＜0.05)，the maximum flexion angle of hip joint，the maximum internal rotation angle of knee joint and the maximum internal rotation angle of ankle joint increased significantly (P＜0.01)，and the maximum dorsiflexion angle of ankle joint decreased (P＜0.05).(3)The kinetic parameters of children with intoeing showed that the maximum flexion moment of the hip joint increased (P＜0.05)，the maximum abductor moment and the maximum power decreased (P＜0.05)，the peak adduction moment and maximum power of knee joint support phase increased significantly (P＜0.01)and the maximum plantar-flexion moment of the ankle joint decreased significantly (P＜0.01).(4)There was a significant linear relationship between the maximum internal rotation angle of hip，knee and ankle，the maximum dorsiflexion angle of ankle and the maximum abduction moment of hip joint and intoeing (P＜0.05).Conclusion The spatiotemporal，kinematic and kinetic parameters of the children with intoeing are significantly different from those of the healthy children.The influencing factors of intoeing are the maximum internal rotation angle of the hip，knee and ankle，the maximum dorsiflexion angle of the ankle and the maximum abduction moment of the hip joint.

Key words： intoeing children gait characteristics three dimensional gait analysis

基金资助:上海市卫生健康委员会科研课题计划项目(20194Y0024)

通讯作者: 姜淑云

作者简介: 张亚茹(1995－ )，女，研究生在读，上海中医药大学附属岳阳中西医结合医院步态与运动分析中心，744046693@qq.com

引用本文:

张亚茹，李阳，李一瀛，俞艳，鲁潇滢，姜淑云. 应用三维步态分析技术评价儿童特发性足内偏的步态参数特征[J]. 实用骨科杂志, 2022, 28(8): 706-711.
Zhang Yaru，Li Yang，Li Yiying，Yu Yan，Lu Xiaoying，Jiang Shuyun. Characteristics of Gait Parameters Evaluated with Three Dimensional Gait Analysis Technique in Children with Intoeing Gait. sygkzz, 2022, 28(8): 706-711.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I8/706

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